Mr A was a factory worker who had worked at the same job for 12 years. Mr A was 37 years old with two teenage children, a stable work history and a positive attitude about his job.

Two months ago on a day like any other, he bent over to pick up an object from the floor, twisting and bending his back to reach the object. As he straightened up he developed acute pain in his back. Mr A had not previously experienced any bother in his back. This pain was new and it was severe.  

Over the following six weeks his back problem improved a little, but he continued to be troubled by substantial pain in when he moved into certain positions and the pain would flare-up easily. There was muscle spasm in his back. 

Two return to work attempts had been unsuccessful, both lasting less than two days.   

A CAT scan showed disc bulges, which he reported to his return to work co-ordinator at his workplace. The coordinator said that this was not significant as lots of people have disc bulges.  Mr A thought the return to work coordinator was frustrated with him not being back at work and treating him unfairly. 

After 12 event-free and fairly happy years in this workplace, Mr A started to feel negatively towards his supervisor. He was obviously worried about his back problem and was sensitive to what seemed like a flippant response to it.

Mr A’s treaters told him to walk and do stretches to do for his back.  However, he was also told to be careful and so he was focussing a lot of his energy on “protecting” his back. Mr A would go to the supermarket with his wife but would not lift the grocery bags, for example, fearful that it might do him some damage.

Since he had begun to experience the pain in his back he had been spending nights worrying about his future, concerned that his back would not improve and unsure about how he would support his family if this occurred.  His main focus was to have an MRI scan to “identify the precise problem” and then work out what was needed to “fix” the problem. 

Mr A had been a stable and reliable employee, husband and father before the incident which hurt his back. Now, after two months of worrying about his pain, his health and his future, sleepless nights and anxiety, he was starting to argue with his wife and spend less time with his children. He began to resent his workplace. 

In this common scenario there is an all too common ending: as time goes on it becomes less and less likely Mr A will return to work. As his worries begin to be realised and is life is impacted further by his back pain, the stress on marriage will increase, as will his general anxiety. He will begin to less confident in his ability to work – a major part of how he defined his life and his purpose in it.

Mr A needed right from the beginning – from the day his back began to hurt - good advice to help get him back to function and the best return to work outcome.  He needed someone to ask him about his fears and anxieties all the way along so they could be addressed.

It is his responsibility to communicate his pain and his concerns; and it is his employer’s and health care providers’ to listen and respond sensitively, giving accurate information and encouraging immediate return to activity.

Dr Indahl interview - Back problems from Return to Work Matters on Vimeo.