FEATURE INSIGHT
Employee back pain
Pamela Gellatly, chairman of Healthcare RM, sets out the surprising issues that most organisations don’t know about
M ental health is often thought to be the highest incidence of ill health in an organisation (after excluding minor illnesses) due to the longer episodes of absence. However, musculoskeletal disorders (MSDs) normally rank higher for sickness absence and across the range of employee benefits thus incurring a far greater cost to employers. Incidence of case management referrals may be very similar between mental health and MSDs but healthcare plan incidence accounts for circa 50% of all claims and costs regularly accrue around 40% of overall spend. In addition, we may be led to believe that musculoskeletal conditions are often caused or made worse by work, but objective assessment by practitioners who research the broader issues – psychosocial factors, excess weight, inactivity and lack of strength and conditioning – suggest that work-relatedness is far lower than is often suggested. Many MSDs have no clear clinical diagnosis, and are often the result of normal everyday activity. For example, only 15% of low back pain can be attributed to an actual clinical diagnosis, suggesting that 85% have a possible range of other causative or contributory risk factors, such as physical, psychological and social stressors. For instance, excess weight around the stomach can increase the load on the lower back muscles and the pelvis, possibly also affecting posture, and increasing strain on the low back and hips. Lack of activity can weaken the skeletal muscle system and stress can manifest as musculoskeletal pain. Research into magnetic resonance imaging (MRI) scan results clearly shows that individuals experiencing the same condition, such as degenerative disc disease (often normal ageing), do not equally suffer pain. The split between those who do and those who don’t is roughly equal, suggesting that the ‘medical label’ is not
necessarily the cause of the pain. It raises the question, why do some people get pain and some not, even though the MRI scan shows the same issue? why do some people get pain and some not, even
diabetes, cardiac and much more. The business case for handling MSDs in a better way is clear – and for very important reasons. The UK has an ageing population and a looming shortage of employees able to engage in the multiple array of skills now required in modern business life. Yet the focus on helping employees to prevent and manage their own health may not only dramatically reduce sickness absence and intervention costs but should also improve productivity. One major employer that has embarked on this journey is not only realising substantial cost savings well within the first year but also improving the quality of life of employees and their families. Although previously providing many of the traditional support services – including a large and effective occupational health, physiotherapy and wellbeing service – this new approach has been described as “someone has just put the lights on”. As a business, it means they are also more effectively managing their health, safety and wellbeing issues. They have reduced the number of health providers, removed unnecessary and or inappropriate interventions and totally integrated service provision. They now have very detailed data on occupational and personal risk factors that affect their people and their business, which means that they can provide targeted solutions and improve outcomes. It is already delivering cost savings well beyond expectations. As we live longer, the burden of the social care system has become well- publicised, but investment in the more traditional medical model will fail to address the real issues. Helping employees understand what they can do to be younger for longer will mean that they achieve a better quality of life, not only whilst at work, but to ensure a healthier and happier retirement. n
though the MRI scan shows the same issue?
Traditionally, support has been via an occupational health or physiotherapy provider, but clinical approaches are no longer the solution in isolation. Indeed, the latest 2016 National Institute for Health and Care Excellence guidelines suggest that exercise and the management of psychosocial factors are key components, and it is believed by a growing number of healthcare professionals that the management of these factors now needs to be significantly different to current medical practice. Future treatment pathways will involve a focus on patient education and self- responsibility including provision of exercises not only to address the symptoms but to help individuals understand how to maintain a healthy skeletal muscle system more akin to the training of sports medicine professionals. Identification and management of psychosocial factors consider the broader person-centered issues such as negative attitudes, beliefs and fears which can also affect mental health. By providing the individual with an understanding of what can affect their physical and psychological health, we have the opportunity to manage not only musculoskeletal disorders but a range of other modern diseases such as anxiety, depression, digestive problems,
| Professional in Payroll, Pensions and Reward | June 2017 | Issue 30 44
Made with FlippingBook - professional solution for displaying marketing and sales documents online