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Best medicine

Returning to work promises a quick cure to musculoskeletal disorders and a reduced cost to the economy
on th jobAs part of its Work, Health and Wellbeing Strategy, the UK government needs to urgently rethink how health agencies coordinate the treatment of musculoskeletal disorders (MSD); how much support it gives to small businesses and its understanding of the impact on labour of MSDs.

This comes from a report by The Work Foundation that looks at the economic and social impact of MSDs ñ by far the most prevalent cause of work-related illness in the UK.

MSDs - an umbrella term for over 200 ailments ranging from arthritis to back pain and damage to joints, muscles and tendons - affect twice as many people as stress-related illness and result in 9.5 million lost working days per annum, at a cost of £7.4bn to the country.

MSDs affect all industries, but listed among the most high-risk occupations are health and social care and caring personal services.

The Work Foundation report argues that early intervention and an emphasis on keeping sufferers in the workplace will more than likely boost national productivity and reduce the current figure of 2.6 million incapacity benefit claims a year.

According to the report, people affected by an MSD are also likely to suffer from mental health problems. The chances of a swift return to work after an MSD-related absence are thus increased if people retain positive mental health, which is aided by the support of their families and employers.

Work can be both cause and cure, said Michelle Mahdon, senior researcher at The Work Foundation. It may cause or aggravate symptoms of MSDs, but evidence is amassing that, with the right support arrangements, work can also be part of the recovery by contributing to a person's self-esteem and sense of being productive.

What urgently needs to change is the attitude of many GPs and employers that an MSD sufferer must be 100 per cent well before any return to work can be contemplated. Too many see only incapacity rather than capacity.

What is needed

To encourage a more swift return to work, The Work Foundation Report recommends:

  • Early intervention: long periods away from work can be negative, and a good balance between the need for respite and need to work should be sought. For some MSD patients, early access to physiotherapy and/or drug therapies will reduce the impact and progression of the condition
  • Better job design: managers are encouraged to change the way that work is organised ñ timing, task allocation and improved ergonomics
  • Enhanced measurement of the direct and indirect costs of MSDs: improved mechanisms to assess and monitor the social and work impact of MSDs is necessary. The National Institute for Health and Clinical Excellence (NICE) is urged to take labour market impacts into consideration when examining the economic effectiveness of different therapies. For example, a person being kept in work and off incapacity benefits will drastically affect decisions regarding drug therapy cost-effectiveness.

The biopsychosocial model of health, which emphasises the interplay between biological (eg, disease, strain), psychological (eg, disposition, anxiety) and social (eg, work demands, family support) factors, provides a useful tool for assessing causes and planning treatment and rehabilitation, The Work Foundation states.

16th October 2007

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