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