In any business, large or small, workers are the most valuable asset. Back disorders are the most common form of ill health at work.

Tackling back pain needs good management and a partnership approach. Employers, workers and others, such as safety representatives and trade union safety representatives, all have roles to play in this approach.

This information is designed to help employers and managers prevent and manage the effects of back pain in the workplace, particularly in small businesses. Employees should also find it useful.

Preventing work-related injuries, including musculoskeletal disorders such as back pain, and managing them in the workplace is one of the priorities for the Health and Safety Commission (HSC).

HSE's key messages about musculoskeletal disorders (MSDs) are:

-- you can do things to prevent or minimise MSDs;

-- the prevention measures are cost effective;

-- you cannot prevent all MSDs, so early reporting of symptoms, proper treatment and suitable rehabilitation is essential.

Please note this is an update of the free leaflet 'Back in Work: Managing back pain in the workplace' (INDG333)

PREVENTING AND ALLEVIATING BACK PAIN, MANAGING BACK PAIN IN THE WORKPLACE

You can reduce the incidence and/or severity of back pain by:

-- carefully examining what could cause harm to people and deciding if you have taken the necessary precautions. This is called a risk assessment;

-- eliminating or reducing the risks that can cause back pain. This could mean changing the way the work is organised or introducing lifting equipment;

-- designing the task and the workplace to take account of the risks; and

-- reviewing the situation in conjunction with the workforce to ensure the changes are effective.

You have a duty under health and safety legislation to make sure the risks to health in the workplace are properly controlled. Manual handling (including lifting, bending, twisting), poor posture (such as sitting at a poorly designed workstation or PC) and whole body vibration (which occurs, for example when you drive heavy vehicles) are known risk factors for back pain. Accidents, such as trips and falls can also be a factor.

Talk to your staff; they know what they find difficult and often have good ideas about how to improve things. Involving workers and safety representatives in discussions about how to improve health and safety will also make it easier to agree changes and workers will be more likely to follow procedures that they have helped to design. If there are safety representatives appointed by trade unions that you recognise, the law requires you to consult them.

Some general tips to help avoid problems include:

-- making sure loads are not handled above shoulder height or in cramped working areas;

-- arranging cover for holidays and unexpected absences so that individuals are not left to cope alone with handling normally done by two or more workers; and

-- keeping the workplace clear of obstructions that can cause trip and slip accidents when handling loads.

BACKPAIN - ADVICE FOR WORKERS

Here is a list of simple do's and don'ts that will help you deal with back pain and let you get on with your life.

DO'S

-- Do stay as active as usual, if possible. But see your doctor if you are worried about the back pain or if the pain persists or suddenly gets worse.

-- Do take simple pain relief to help with the pain.

-- Do speak to your employer or your workers' representative, your safety representative or a trades union safety representative who can relay your issues to your employer and if necessary, discuss what can be done to help you stay at work.

-- Do find out about back pain. A summary of good advice can be found in guidance booklets like. The Back Book

DON'TS

-- Don't take to your bed and wait for the pain to go away. The sooner you get back to normal activity the better.

-- Don't worry. Back pain is rarely serious and unnecessary worry delays recovery.

-- Don't avoid activity simply as a way of avoiding the pain - hurt does not always mean harm.

BACKPAIN - ADVICE FOR EMPLOYERS

WHAT CAN I DO TO HELP A WORKER WITH BACK PAIN?

As an employer, you can do a lot to help any of your staff that report back pain. It is very important to be positive and helpful in removing obstacles to their recovery.

-- Make sure they have the right information and advice on how to cope with back pain and lead a normal life. The easiest way to do this is to give them a copy of an information booklet; The Back Book is recommended.

-- Reassure them that you are concerned about them and want to help. Ask what they find difficult about the job. This may give you a chance to make jobs less physically demanding as a temporary measure to help them stay at work or return to work quickly

-- If they have seen their doctor, tell them you are willing to discuss the situation with the doctor and to work with them to support any treatment that is recommended. -- If they go off sick it is important to keep in touch. Discuss whether modified work or a gradual build-up to normal duties will help them return to work.

WHAT IF A WORKER DOES NOT RECOVER IN A FEW WEEKS?

If the pain continues, it is important that the sufferer consults a medical practitioner to check that the condition is not serious. Because back pain has many causes, a precise diagnosis is not always possible, and this makes management of the pain all the more important.

Most workers should be able to return to some form of work within two weeks. If an employee has not been able to return by then, consider possible measures to help their recovery and return to work. Involving those treating your employee and perhaps your occupational health staff will help you in the discussion about such measures. These could include physiotherapy or other manipulative treatments. It could also mean looking at changes to working conditions and helping the worker learn to cope.

Arranging treatment and rehabilitation will be easier for large businesses that have their own specialists and an occupational health service. But small businesses can also have access to these kinds of arrangements.

-- Some have 'good neighbours'. Some large companies offer small businesses in their supply chain access to their support services.

-- Some go it alone. Some small businesses find it worthwhile to make local partnership arrangements with health professionals. These contacts can also help advise on how to avoid risk in the workplace.

-- Some make arrangements through their employer's liability insurance. Most insurers now offer this sort of service.

However, not all therapies are equally effective and not all providers follow evidence-based good practice. The provider should be aware of this guidance. Make sure they know you have a system for providing modified work and will support early return-to-work arrangements.

BACKPAIN - SUMMARY

Back pain is a major problem for both employers and employees. You have a duty under the law to protect your workers and to care for their health at work.

There is a lot you can do to prevent back pain in your workplace by:

-- involving your employees;

-- assessing the risks and finding ways to avoid or reduce them;

-- providing training and information to your workforce.

It is important for a worker to get back to work as soon as possible. You will need to carry out a new risk assessment when they return to check whether changes need to be made to the tasks they do either temporarily or permanently. You can help them fully recover by gradually returning them to normal work.

If someone suffers for more than six weeks, the condition is termed 'chronic'. But with suitable treatment and rehabilitation many people return to a normal life.

So..... to stop back pain recurring, keep fit and stay active.

REMEMBER�

-- things can be done to prevent or minimise back pain;

-- preventative measures are cost-effective;

-- you cannot prevent all back pain; so early reporting of symptoms, proper treatment and suitable rehabilitation is essential.

FEEDBACK

We are interested in your views and experiences of dealing with back pain. Please fill in our feedback form.

-- What worked for you?

-- What would you recommend?

-- What do you think of our advice and guidance?

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Health and Safety Executive, UK