Low back pain patients' experiences of work modifications; a qualitative study.
BACKGROUND
Research indicates that work modifications can reduce sickness absence and work disability due to low back pain. However, there are few studies that have described modified work from the perspective of patients. A greater understanding of their experiences may inform future workplace management of employees with this condition.


METHODS
Individual semi-structured interviews were conducted with twenty-five employed patients who had been referred for back pain rehabilitation. All had expressed concern about their ability to work due to low back pain. Data was analysed thematically.


RESULTS
Many participants had made their own work modifications, which were guided by the extent of control they had over their hours and duties, colleague support, and their own beliefs and attitudes about working with back pain. A minority of the participants had received advice or support with work modifications through occupational health. Access to these services was limited and usually followed lengthy sickness absence. Implementation largely rested with the manager and over-cautious approaches were common.


CONCLUSIONS
There was little evidence of compliance with occupational health guidance on modified work. There appears to be insufficient expertise among managers and occupational health in modifying work for employees with low back pain and little indication of joint planning. On the whole, workers make their own modifications, or arrange them informally with their manager and colleagues, but remain concerned about working with back pain. More effective and appropriate application of modifications may increase employees' confidence in their ability to work.
Division of Rehabilitation and Ageing, School of Community Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK. carolyn.coole@nottingham.ac.uk
Carol
C
Coole
Paul J
PJ
Watson
Avril
A
Drummond
D000328:Adult; D000368:Aged; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D017116:Low Back Pain / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D010349:Patient Compliance; D012017:Referral and Consultation; D012649:Self Concept; D018582:Sick Leave; D016526:Workload / Q000592:standards*