Research has shown that work is, generally speaking, good for one’s health and wellbeing. Furthermore, being out of work is detrimental to one’s health. This implies that work is the latest ‘tool’ in the toolbox that healthcare providers have available to treat their patients. It also means that sick certification may actually hamper good health. This is especially true in musculoskeletal conditions such as back pain, where staying active has proven to be essential in an effective management regime. The fact that most of us spend considerable time at work, going to work should be seen as part of the staying active regime. In some cases, though, work may have to be (temporarily) adapted to suit the ability of the employee with back pain. The information below highlights the role a healthcare provider plays in using work to improve an employee’s or patient’s health.

What can I do as a healthcare provider? 

Employment is a very powerful clinical tool and for this reason it is useful for all healthcare providers to familiarise themselves with the evidence that supports the link between work and health. A good starting point is the evidence review by Waddell & Burton which was published by The Stationary Office in 2006 . Many of the conclusions of this review form the basis of the text presented here.

Many patients turn to their GP or other healthcare provider for reliable information about their health status. This gives a unique opportunity for the healthcare provider to discuss employment and the role of employment in health. Although some patients may feel that they need a period of sick leave, it is also important to show the other side of the medal. Most patients with back pain are better off by remaining at work or returning to work swiftly.

To achieve this it may be necessary explore the (perceived) barriers to returning to or remaining at work. Discuss what a patient is able to do in his/her condition and how this relates to his/her work. This gives valuable information to the patient who can then discuss this with their employers in order to agree a working regime that assists them with recovery. Set realistic goals and manage expectations, but in terms of healthcare and employment. The Working for Health website ( www.workingforhealth.gov.uk ) has a wealth of information on this topic.

Assisting job seekers 

There is general consensus that employment is good for someone’s health and being out of work is often detrimental to one’s health and well-being. This suggests that assisting a patient with back pain to seek employment may have a positive impact on their health. Some patients may experience barriers that ‘prevent’ them from seeking employment and it may be helpful to explore these perceived barriers with your patient. This is very similar to a patient with back pain who wants to remain at or return to work.

In your conversation with the patient it may be...

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