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Returning Back Pain Patients to Work: How Private Musculoskeletal Practitioners Outside the National Health Service Perceive Their Role (an Interview Study)

Journal of Occupational Rehabilitation volume 20, pages 322–330 (2010)Cite this article

Abstract

Background Private musculoskeletal practitioners treat a large section of people with back pain, and could play an important role in returning and maintaining patients to work. Method We conducted a qualitative study to explore the self-perceived role of such practitioners in the UK. We interviewed 44 practitioners, including chiropractors, osteopaths and physiotherapists. Results Thematic analysis of the interview transcripts indicated that return to work is a high priority for patients, many of whom are self-employed. Although in general work was perceived as beneficial to health, practitioners perceived work as a threat for some of their back pain patients. They perceived their role as giving ergonomic, postural and exercise based advice, but were more reluctant to address psychosocial problems related to back pain. A common view was that patients’ reluctance to take a break from work impacted badly on their condition, and many practitioners advocated a short time off work duties to focus on rehabilitation. Contact with employers was very limited, and determined by the patients’ request. Conclusion In summary, the study identifies several areas in which further education could expand the role of musculoskeletal practitioners and benefit their back pain patients. However, further study is required to determine whether these results are generalisable beyond the limits of this qualitative study UK based study.

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References

  1. Waddell G. Preventing incapacity in people with musculoskeletal disorders. Br Med Bull. 2006;77–78:55–69.

    Article  PubMed  Google Scholar 

  2. Waddell G, Burton A, Main C. Screening to identify people at risk of long-term incapacity for work: a conceptual and scientific review. London: Royal Society of Medicine Press; 2003.

    Google Scholar 

  3. Franche RL, et al. Workplace-based return-to-work interventions: a systematic review of the quantitative literature. J Occup Rehabil. 2005;15(4):607–31.

    Article  PubMed  Google Scholar 

  4. Waddell G, Burton AK. Occupational health guidelines for the management of low back pain at work: evidence review. Occup Med (Lond). 2001;51(2):124–35.

    Article  CAS  Google Scholar 

  5. Koes BW. Clinical guidelines for the management of low back pain in primary care: an international comparison. Spine (Phila Pa 1976). 2001;22:2504–13. discussion 2513–4.

    Google Scholar 

  6. Staal JB, et al. Occupational health guidelines for the management of low back pain: an international comparison. Occup Environ Med. 2003;60(9):618–26.

    Article  CAS  PubMed  Google Scholar 

  7. Shaw WS, et al. Early patient screening and intervention to address individual-level occupational factors (“blue flags”) in back disability. J Occup Rehabil. 2009;19(1):64–80.

    Article  PubMed  Google Scholar 

  8. Beaumont D. Rehabilitation and retention in the workplace—the interaction between general practitioners and occupational health professionals: a consensus statement. Occup Med (Lond). 2003;53(4):254–5.

    Article  Google Scholar 

  9. Beaumont DG. The interaction between general practitioners and occupational health professionals in relation to rehabilitation for work: a Delphi study. Occup Med (Lond). 2003;53(4):249–53.

    Article  CAS  Google Scholar 

  10. Sawney P, Challenor J. Poor communication between health professionals is a barrier to rehabilitation. Occup Med (Lond). 2003;53(4):246–8.

    Article  Google Scholar 

  11. Pincus T, et al. The attitudes to back pain scale in musculoskeletal practitioners (ABS-mp): the development and testing of a new questionnaire. Clin J Pain. 2006;22(4):378–86.

    Article  PubMed  Google Scholar 

  12. Foster NE, et al. Illness perceptions of low back pain patients in primary care: what are they, do they change and are they associated with outcome? Pain. 2008;136(1–2):177–87.

    Article  PubMed  Google Scholar 

  13. Haetzman M, et al. Chronic pain and the use of conventional and alternative therapy. Fam Pract. 2003;20(2):147–54.

    Article  CAS  PubMed  Google Scholar 

  14. Royal College of General Practicioners (RCGP). Clinical guidelines for the management of acute low back pain. 1999. Available from: http://www.rcgp.org.uk/rcgp/clinspec/guidelines/backpain/.

  15. Pincus T, et al. Attitudes to back pain amongst musculoskeletal practitioners: a comparison of professional groups and practice settings using the ABS-mp. Man Ther. 2007;12(2):167–75.

    Article  PubMed  Google Scholar 

  16. Shaw WS, et al. Perceptions of provider communication and patient satisfaction for treatment of acute low back pain. J Occup Environ Med. 2005;47(10):1036–43.

    Article  PubMed  Google Scholar 

  17. Pincus T, et al. Fear avoidance and prognosis in back pain: a systematic review and synthesis of current evidence. Arthritis Rheum. 2006;54(12):3999–4010.

    Article  PubMed  Google Scholar 

  18. Shaw WS, et al. Patient clusters in acute, work-related back pain based on patterns of disability risk factors. J Occup Environ Med. 2007;49(2):185–93.

    Article  PubMed  Google Scholar 

  19. Shaw WS, Linton SJ, Pransky G. Reducing sickness absence from work due to low back pain: how well do intervention strategies match modifiable risk factors? J Occup Rehabil. 2006;16(4):591–605.

    Article  PubMed  Google Scholar 

  20. Pincus T. Cognitive-behavioral therapy and psychosocial factors in low back pain: directions for the future. Spine (Phila Pa 1976). 2002;27(5):E133–8.

    Google Scholar 

  21. National Institute for Health and Clinical Excellence (NICE). The guidelines manual. 2009. Available from: http://www.nice.org.uk/aboutnice/howwework/developingniceclinicalguidelines/clinicalguidelinedevelopmentmethods/GuidelinesManual2009.jsp. Accessed 2009.

  22. Williams NH. Optimising the psychological benefits of osteopathy. International Journal of Osteopathic Medicine. 2007;10(2–3):36–41.

    Article  Google Scholar 

  23. Williams NH, et al. Psychological response in spinal manipulation (PRISM): a systematic review of psychological outcomes in randomised controlled trials. Complement Ther Med. 2007;15(4):271–83.

    Article  PubMed  Google Scholar 

  24. Burton K. Viewpoint. Int J Osteopath Med. 2006;9(2):56–7.

    Article  Google Scholar 

  25. Dobyns JH. Role of the physician in workers’ compensation injuries. J Hand Surg Am. 1987;2(5 Pt 2):826–9.

    Google Scholar 

  26. Quinn PR. Returning to work after disability. Empl Benefits J. 2002;27(2):13–7.

    PubMed  Google Scholar 

  27. Hasenbring MI, Hallner D, Rusu AC. Fear-avoidance- and endurance-related responses to pain: development and validation of the Avoidance-Endurance Questionnaire (AEQ). Eur J Pain. 2009;13(6):620–8.

    Article  PubMed  Google Scholar 

  28. Vlaeyen JW, Morley S. Active despite pain: the putative role of stop-rules and current mood. Pain. 2004;110(3):512–6.

    Article  PubMed  Google Scholar 

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Affiliations

  1. Department of Psychology, Royal Holloway, University of London, Egham, Surrey, TW20 0EX, UK

    Tamar Pincus & Alison Woodcock

  2. British School of Osteopathy, London, UK

    Steven Vogel

Authors
  1. Tamar Pincus
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  2. Alison Woodcock
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  3. Steven Vogel
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Correspondence to Tamar Pincus.

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Pincus, T., Woodcock, A. & Vogel, S. Returning Back Pain Patients to Work: How Private Musculoskeletal Practitioners Outside the National Health Service Perceive Their Role (an Interview Study). J Occup Rehabil 20, 322–330 (2010). https://doi.org/10.1007/s10926-009-9217-9

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  • DOI: https://doi.org/10.1007/s10926-009-9217-9

Keywords

  • Back pain
  • Return to work
  • Perceived role of practitioners