Back pain may be the ubiquitous “nudge nudge, wink wink” excuse when it comes to sickies, but the reality is a far cry from the popular perception of this common workplace injury.
In fact, new research shows most workers are reluctant to take action if they injure themselves, especially when it comes to back pain, while SMEs are shouldering the bulk of the financial pain when it comes to rehabilitating their employees.
The Konekt Market Report, which is the largest of its kind in Australia, analysed more than 113,000 cases of workers compensation and non-compensable cases over a six year period. It found that while lower back pain is the second-greatest contributor of disability in Australia, employees either take their time reporting injuries or ignore them until they become debilitating. Worryingly for business, a cost-of-illness study carried out in Australia estimated the indirect costs associated with low back pain to be $8.15 billion due to loss of earnings and productivity.
Musculoskeletal injuries represented the largest workplace injury category, with back injuries accounting for almost one third. And in the compensable environment ‘back strain’ injuries represented almost one in five serious injury claims over the last decade.
About three million Australians (14% of the population) suffer from low back pain, and according to the Australian Institute of Health and Welfare, $5.7 billion was spent on arthritis and other musculoskeletal conditions in 2008-2009, with $1.18 billion of that specifically on back problems.
“Last financial year saw an increase in the number of referrals being made relating to back injuries,” says Nicholas Ward, Product Manager with Konekt. “While the total number of claims is decreasing and the average time lost associated with back strain injuries halved between 2000 and 2001 and 2010 and 2011, alarmingly we noticed an increase in the average delay from when an injury occurs to when it is reported and then referred for support and return to work services.”
Professor Chris Maher, director of the University of Sydney Medical School Musculoskeletal Division and one of the world’s top back pain specialists, says there are numerous misconceptions about the causes and treatment of back pain.
”We know that the worker with back pain, their employer and the clinician managing the worker’s back pain may misunderstand back pain, so we really need to think about educational programs targeting each of those groups,” Professor Maher says.
The Konekt Market Report also showed males aged between 30 and 39 had the highest incidence of back injuries, and were more likely to report them (65%). Back injury claims made by women to employers/healthcare professionals rose from 33% to 39% over the past decade.
Professor Maher says in general back pain is more common in women than in men – and that there’s a very strong genetic predisposition to getting back pain. “Before we used to think that back pain was mainly caused by injury and poor lifestyle, but I think we’re now starting to realise that a person’s genes can also influence how much back pain they experience,” he says.
SMEs shouldering the burden
Data showed small and medium employers are shouldering the burden through higher rehabilitation costs. Significantly, small employers are, on average, waiting 114 weeks to refer employees for rehabilitation services.
“We found that the return to work rate for small business is 85%, compared with 90% for large businesses,” Nicholas Ward says. “Smaller businesses are less likely to have internal expertise in relation to injury management [and] will be more reliant on external providers.”
Professor Maher says one of the most important things that employers/managers can do to help workers with back pain is to become educated about the condition.
“Our understanding of how to best manage back pain has changed in the last decade. For example, surgery really has a quite limited role for workers with back pain,” he says. “Doctors are also now more cautious with opioid medicines because if they are not used carefully they can cause harm. We know from Australian and overseas data that people are unfortunately dying from taking prescription opioid medicines for their back pain.”
There’s plenty of good news
On a positive note, the report found that the average return to work rate has improved, and in the past financial year 94% of those referred for return to work assistance (treatment / rehab) achieved a successful return to work outcome. But the report highlighted the importance of early intervention (identifying the problems and referring workers for treatment early) by workers, employers/managers and healthcare clinicians. Those referred within the first two weeks post injury achieved a 97% return to work rate compared with a 72% return to work rate for those referred greater than two years. The report also shows that the average duration and the average service costs increase with the duration of disability.
While there is often no obvious cause for a person’s back pain, Professor Maher says there are some simple steps that could be taken to prevent it. “Avoiding smoking, having a healthy diet and a healthy amount of alcohol, undertaking physical activity, and using your back sensibly,” he says.And while prevention is all very well, once the back pain is there it needs to be dealt with. “There are several steps people can take to help themselves get better,” Professor Maher says. “The contemporary approach is don’t go to bed. Rather, try to stay physically active – you don’t need an x-ray and you should try to remain at work.”