title: What Challenges Manual Workers' Ability to Cope with Back Pain at Work, and What Influences Their Decision to Call in Sick?
abstract: BACKGROUND
  Although back pain (BP) is a very common cause for sickness absence, most people stay at work during BP episodes. Existing knowledge on the factors influencing the decision to stay at work despite pain is limited. The aim of this study was to explore challenges for coping with BP at work and decisive factors for work attendance among workers with high physical work demands.
  
  
  METHODS
  Three focus groups (n = 20) were conducted using an explorative inductive method. Participants were public-employed manual workers with high physical work demands. All had personal BP experience. Thematic analysis was used for interpretation. Results were matched with the Flags system framework to guide future recommendations.
  
  
  RESULTS
  Workers with BP were challenged by poor physical work conditions and a lack of supervisor support/trust (i.e. lack of adjustment latitude). Organization of workers into teams created close co-worker relationships, which positively affected BP coping. Workers responded to BP by applying helpful individual adjustments to reduce or prevent pain. Traditional ergonomics was considered inconvenient, but nonetheless ideal. When pain was not decisive, the decision to call in sick was mainly governed by workplace factors (i.e. sick absence policies, job strain, and close co-workers relationships) and to a less degree by personal factors.
  
  
  CONCLUSIONS
  Factors influencing BP coping at work and the decision to report sick was mainly governed by factors concerning general working conditions. Creating a flexible and inclusive working environment guided by the senior management and overall work environment regulations seems favourable.
authors: Copenhagen Center for Back Research (COPE BACK), Centre for Rheumatology and Spine Diseases, Glostrup University Hospital, Ndr. Ringvej 57, 2600, Glostrup, Denmark. frederiksarbejde@outlook.dk.|Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. frederiksarbejde@outlook.dk.
authors: Pernille
authors: P
authors: Frederiksen
authors: Copenhagen Center for Back Research (COPE BACK), Centre for Rheumatology and Spine Diseases, Glostrup University Hospital, Ndr. Ringvej 57, 2600, Glostrup, Denmark.|Department of Anthropology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark.
authors: Mette Marie V
authors: MM
authors: Karsten
authors: Department of Research and Development, Clinic Physical Medicine and Rehabilitation, Vestfold Hospital Trust, Stavern, Norway.|Uni Health, University of Bergen, Bergen, Norway.
authors: Aage
authors: A
authors: Indahl
authors: Copenhagen Center for Back Research (COPE BACK), Centre for Rheumatology and Spine Diseases, Glostrup University Hospital, Ndr. Ringvej 57, 2600, Glostrup, Denmark.|Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors: Tom
authors: T
authors: Bendix
mesh_terms: D000328:Adult; D001416:Back Pain / Q000523:psychology*; D003657:Decision Making; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D016134:Organizational Policy; D010147:Pain Measurement; D005082:Physical Exertion; D000069597:Presenteeism; D036301:Qualitative Research; D018582:Sick Leave; D012944:Social Support; D013315:Stress, Psychological / Q000523:psychology; D016526:Workload; D017132:Workplace / Q000458:organization & administration
keywords: Back pain; Focus groups; Sick leave; Sickness absence; Social support; Workplace