Musculoskeletal Matters 5

MUSCULOSKELETAL MATTERS A r t h r i t i s Re s e a rc h U K P r i mary ity C a re s r C e n t r e , Ke e l e U n i ve 5: Supporting Return to Work Work absence and musculoskeletal pain • Over 9.5 million working days are lost each year in the UK due to musculoskeletal disorders. • The majority of people on sick leave return to work within 2 weeks, but the longer the absence, the lower the probability of long-term successful return to work (Waddell & Burton, 2006) Length of work absence At work 12 months later less than 4 weeks > 90% 4 – 12 weeks 60 – 90% more than 6 months 10% • Unemployment and unnecessary prolonged sickness absence are generally bad for physical and mental health and wellbeing. In many people work can be therapeutic and help to promote recovery (Waddell & Burton, 2006). Outcome of sickness certification in primary care • In a cohort of 806 primary care consulters with back pain (BeBack), 14% received a sickness certificate. Patients receiving a sick note reported more pain, more disability, less confidence in managing their pain (‘self-efficacy’) and more anxiety and depressive symptoms (Lewis, Wynne-Jones et al. in preparation). • Six months after the consultation for back pain, scores on these measures were still higher in those who had received a sick note (see figure). This group had also consulted their GP more often with back pain (mean 3.2 versus 1.9 consultations) and reported more work absence (mean 36.6 versus 7.8 days) during the 6 months following the consultation. 9 sick note 8 These bulletins are designed to provide information for general practitioners, the primary care team, teachers, trainers and policy makers about musculoskeletal problems in practice no sick note 7 6 5 4 3 2 1 0 pain disability anxiety self-efficacy Mean scores at 6 months after receiving a sick note: higher scores indicate more pain, disability and anxiety but better self efficacy levels June 2012