When an employee has low back pain? ACT! A three-step guide for managers and team leaders


Of the 131 million days lost to sickness annually, 23% are due to musculo-skeletal disorders, of which back pain is the most frequent. In fact low back pain is the most common reason people are unable to work. But far more are thought to carry on working despite suffering with it. And 1 in 8 people who are not working give back pain as the reason they are unable to work.


With estimates that 8 of 10 people will experience back pain at some time, it’s an issue that, directly or indirectly, affects us all,.


So what is the best course of action?


The research and advice is conflicting and confusing: ‘It’s better to be at work’, but ‘being at work when unfit is unproductive and negatively affects colleagues’…

’Going back to work too soon will mean recovery takes longer’… ‘staying away from work risks isolation and depression’…


It’s not easy to know the best solution.


What’s the government advice?

The National Institute for Health and Clinical Excellence (NICE) guidelines for low back pain include staying as active as possible, manual treatment such as osteopathy, a specific exercise programme, psychological support, if there is no improvement, and medical review in six weeks. However six weeks is a long time if you’re not improving!


Work absence can be almost halved if treatment starts early.

A study in Spain involving 13,000 people, who started a similar combined treatment approach, within five days of onset, reduced absence by 40%, speeded up recovery, and returned a cost saving of 11 euros for every 1 euro spent on the programme.


So it pays to be proactive.


Here’s a simple guide to follow:



Ninety-five per cent of all cases of low back pain are not caused by serious or life threatening conditions. So most do not require medical attention, even though the pain may be very severe and extremely debilitating.

An ideal primary care option is an osteopath. Osteopaths are back pain specialists, who can set up the treatment package, effectively coordinating care for recovery.

We put our clients in touch with local osteopaths who will

  • Assess and start treatment within 48 hours,
  • Issue a Fit Note, and
  • Provide support, reassurance and advice regarding physical movement
  • Support a phased return to work
  • Refer for medical assessment or further tests if needed


The standard osteopathic treatment protocol includes assessing for serious medical causes for the pain and to refer to a doctor for further tests or medical attention if needed.



When an employee has low back pain, having in place effective communication channels, helps the whole process of recovery.

We look to set in place effective communication protocols so that

  • Employees and team feel confident that, when they seek help, it will be effective and constructive
  • Team members collaborate to help if colleagues are absent or on reduced workload.
  • There are ‘speed dial’ links with local primary health practitioners who are familiar with the needs of your organisation, and can provide treatment at short notice.
  • Local health care providers run talks or information lunch clubs and other staff learning opportunities



Treatment should extend way beyond the ‘fixing what’s broke’ phase. It needs to include

  • Rapid access to active evidence-based treatment
  • Discussion between employer and employee to make sure they are getting the best help possible
  • A phased return to work, using options such as work-from-home, flexi-time, job swap, and mentoring
  • Training for the workplace, team leaders, managers and staff teams, such as ‘back pain self-management’ courses, on-site wellbeing training and work station assessments
  • Support to prevent longterm absence or relapse, by creating healthy workplace habits, layout and systems

Organisations that we work with, to create this proactive strategy into their culture, are seeing a reduction in the financial and the social costs of low back pain for both the individual and the organisation as a whole.


And the most important benefit?

… a happy and healthy workplace culture, where people can achieve amazing things.



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