Back injuries: getting injured workers back to work

BACKGROUND: Back problems are the seventh most common reason for seeking care in general practice in Australia. Despite medical advances, chronic disability from back pain is a major contributor to the burden of disease in society today. OBJECTIVE: This article provides an overview of evidence based management for workers presenting with acute low back pain, with the aim of minimising the risk of chronic disability. DISCUSSION: Approximately 95% of cases of acute low back pain are nonspecific. Serious spinal conditions are rare and can be identified by triaging for 'red flags'. A modern biopsychosocial approach does not require a specific patho-anatomic diagnosis for effective management. It is essential to reassure patients to stay active and to resume normal activities quickly - including return to work. Screening for environmental and psychosocial 'yellow flags' can identify patients at risk of poorer outcomes so that additional early intervention can commence. (author abstract)