DWP AnD BACk PAin
heal, the injury event must not be the pain had gone and risk starting down in providing more comprehensive and
repeated, and its social and occupational the road to becoming unemployed? robust fitness-for-work advice [a new
effects must be put right. This must be Would you refuse to work until the work Med 3 will be rolled out next year and
right. HSE [now under the DWP umbrella] had been adjusted for you? Would will include advice on rehabilitation for
must help prevent it; DWP must help with you endlessly pursue your GP for a the both the employee and employer to
any social consequences. diagnosis when test after test shows discuss]
there is no pathology, only spasm? Tens
Scientific research shows that following of thousands of people follow this path For those on employment and support
a tissue damage event in the back it can every year encouraged and assisted allowance, a higher rate of benefits will
take three years before the frequency by the ‘good fact’. Every year 100,000 be paid to those who engage with return
of reporting back pain episodes reverts people leave work permanently because to work actions such as the condition
to the mean. But what is happening of the ‘good fact’. management programme and work trials
over those three years. Is it perhaps The aim is to educate, support and
something about work which is reinjuring For many and for far too long the ‘good advise customers on how to manage
the wound? Is it hypersensitivity about fact’ has been the only fact. There needs their condition and to improve their
unremarkable pain leading to a tendency to be a balance and DWP has decided functional ability using the principles of
to notice and report it? Is it that the back the balance starts now. Cognitive Behavioural Therapy.
is more likely to be in significant pain?
The management of the work and social Some quotes from DWP publications The Customer:
effects of post injury pain will depend help explain what they are doing about it. • understands more about his/her
critically on which of these is correct. condition and how it can be safely
The pain = injury equation will obviously Changing the assumptions: managed in a work setting;
be foremost in everyone’s mind, The idea that people facing illness or • through exploring the health benefits
especially for the person with the painful disability should be protected from work, of returning to work and strategies for
spasm. The ‘good fact’ will drive them whatever their aspirations, is outdated dealing with the condition, feels more
to follow the same path as for a high and can often be detrimental to the confident about seeking work and the
energy injury event. DWP has questioned individual – the opposite of the outcome prospect of remaining in work; and
whether this is in their best interests. the GP intended. • will recognise the early signs of a
relapse or worsening of the condition
The current scientific view is that higher A number of initiatives are planned to help and is better able to take appropriate,
rates of recurrent pain reporting is usually GPs work with patients, to ensure they timely steps to seek help and/or
not due to re-injury unless some new understand the importance of work in reasonable workplace adjustments.
high energy event caused it, worry can recuperation and the negative impacts of
play a role for some people in higher being out of work and can support and For those on incapacity benefit who try
rates of reporting, but mostly, the reason assist people to remain in or return to work: going to work, the system has been
is that the back is more likely to go into changed so that if they have a relapse
spasm for a while even after an injury has • to reward primary care staff who take which prevents work within two years
completely healed. Spasm hurts. It hurts active steps to support individuals to they qualify for IB immediately and at the
as much as an injury, perhaps more, and remain in or return to work; same rate as before the work trial.
for some people, much more. It can be • a national education programme for
triggered by anything but is known to GPs on health and work Essentially these changes mirror the
be more likely during lifting and twisting • working closely with the Chartered BackCare advice to avoid high energy
movements. That’s why so many people Society of Physiotherapists to injuries to the back, but if it happens:
think normal lifting and twisting cause improve the work-focused messages as soon as possible stay active, avoid
injury and is why so much guidance given by their staff actions which trigger disabling spasms,
proclaims the virtues of avoiding it. • supporting the College of Occupational and challenge those who insist on the
Therapists, which is determined to basis of outdated knowledge that you
For many people the pain of spasm is push forward strongly in this area should stay away from work. On those
overwhelming for a brief period. You can’t occasions when the ‘good fact’ is actually
move, even if you know that moving will In Practice correct the system works well but once
help speed relief. the provision of back-to-work services the initial emergency has passed this fact
following self or GP referral. These have must be balanced properly if rehabilitation
On the other hand… been tested by the Pathways to Work is to be successful. Time will tell if the
Once you know it is spasm and not a project. reviewing the format of the DWP approach works out. BackCare will
sign of injury, dread disease and decay medical certificate (FMed 3) to make it help DWP to ensure that the balancing
would you want to be sent home until all more user-friendly and to support GPs remains proportionate. ●
The Backcare Journal 7
backcare Winter 2009/10.indd 7 8/1/10 11:18:41
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