Welcome back to SpineIQ’s Back Blog! This week we will continue with September’s theme of highlighting clinically meaningful research studies with “Staying at work with musculoskeletal pain: what supporting resources do people need?” by Oakman et al.1 Advice to return to work quickly is recommended by clinical practice guidelines for low back pain.2,3 However, the recommendations are usually not detailed enough to be helpful to either clinicians or patients. For example, they often do not address the barriers that patients experience and how clinicians can play a role in helping people return and stay at work during an episode of back pain. Therefore, this study plays an important role in helping us better understand work-related concerns experienced by patients with low back pain.
Purpose and methods of study:
The authors performed a qualitative study using zoom/phone interviews to understand both the work experiences and information-seeking behaviors of people with spine-related pain. The participants were adults (>18 years old) working >8 hours of paid labor a week with at least one episode of low back or neck pain in the last 12 months.
Results:
The large majority of participants sought care from a health professional (e.g., general practitioner, physiotherapist, chiropractor, rheumatologist). An important finding was that while people acknowledged the impact of pain on their work life, they also felt that the benefits of being able to stay at work far outweighed the negative impact of pain. This is not surprising given how much we have learned during COVID about the benefits of “working from home”, but also the psychological and emotional impact of isolation and lack of camaraderie and social interaction. This is important information for clinicians to consider when discussing physical limitations caused by pain versus the benefits that work provides to the individual.
In addition, people reported that resources regarding how to have hard discussions about chronic pain with employers would be a valuable resource. For instance, some people feared that if they disclosed their pain to employers, they would be subject to potential repercussions and stigma.
Finally, most people surveyed sought information online about how to manage their condition. The sheer amount of information available online was seen as a barrier since many did not feel qualified to know what was trustworthy or not. Not surprisingly, people felt that healthcare professionals were the most trustworthy source for information. Clinicians should take advantage of this element of “trust” and encourage work and activity along with the total emotional and psychological benefit that the work experience provides. Many patients rarely hear encouraging words from their doctors regarding aspects of general well-being related to their specific work injury. This is an opportunity to deliver a positive patient experience which will be remembered and valued.
Conclusions:
The findings from this study can be helpful for clinicians as they consider how to help patients continue or return to work during their back pain episode. Patients value open conversations surrounding the effect of back pain on work environments and need such guidance. Additionally, clinicians are viewed as the most valuable source of information regarding pain and most patients report attempting to seek information about their condition and how it impacts work. This is an opportunity for clinicians to be a positive and valuable experience for patients and provide advice that can impact a persons pain experience, self-efficacy, and future behaviors. Finally, clinicians should be prepared to share high-quality resources from their own website/brochures or trusted sites like SpineIQ regarding pain.
References:
- Oakman J, Kinsman N, Briggs AM. Staying at work with musculoskeletal pain: What supporting resources do people need? Musculoskeletal Care. n/a(n/a). doi:10.1002/msc.1591
- National Guideline Centre (UK). Low Back Pain and Sciatica in Over 16s: Assessment and Management. National Institute for Health and Care Excellence (UK); 2016. Accessed June 11, 2021. http://www.ncbi.nlm.nih.gov/books/NBK401577/
- Qaseem A, Wilt TJ, McLean RM, Forciea MA, Clinical Guidelines Committee of the American College of Physicians. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017;166(7):514-530. doi:10.7326/M16-2367