Absence resulting from low back trouble can be reduced by psychosocial intervention at the work place

Symonds, Tara L.; Burton, A. Kim; Tillotson, K. Malcolm; Main, Chris J.

doi:10.1097/00007632-199512150-00016

Cited by 193Musculoskeletal pain and rehabilitationWorkplace Health and Well-beingMedical Practices and Rehabilitation

Absence resulting from low back trouble can be reduced by psychosocial intervention at the work place

Symonds, Tara L., Burton, A. Kim, Tillotson, K. Malcolm, Main, Chris J.·1995·Spine

DOI 10.1097/00007632-199512150-00016

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Abstract

STUDY DESIGN: A 1-year prospective study in industry, assessing effects of an educational pamphlet on various psychosocial parameters and absenteeism resulting from low back trouble. OBJECTIVES: To determine the value of distributing an educational psychosocial pamphlet to reduce absenteeism resulting from back trouble. The pamphlet was designed to alter avoidance behaviors by encouraging a positive, active approach. SUMMARY OF BACKGROUND DATA: Attempts to control back-pain disability have failed. Fear of pain and activity seemingly leads to avoidance behaviors than contribute to chronicity and work loss. Avoidance behaviors are mediated by attitudes and beliefs; such attitudes and beliefs are a reasonable target for educational interventions designed to change "inappropriate" behaviors (e.g., extended absenteeism). Health education pamphlets are advocated widely but tested rarely. METHODS: Three factories participated in the study. Psychosocial data were collected by questionnaires; absence data were extracted from company records. A psychosocial pamphlet was distributed in one factory; the control subjects received either a nonspecific pamphlet or no intervention. The pamphlet emphasized a positive approach to low back trouble (reduction of negative beliefs and attitudes). RESULTS: In the company whose employees received pamphlets, a significant reduction occurred for the number of spells with extended absence and the number of days of absence (70% and 60%, respectively) compared with extrapolated values. A concomitant positive shift in beliefs concerning the locus of pain control and the inevitable consequences of low back trouble was found. CONCLUSION: A simple industrial intervention using a psychosocial pamphlet, which was designed to reduce avoidance behaviors by fostering positive beliefs and attitudes, successfully reduced extended absence resulting from low back trouble.

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Kinesiophobia is a strong predictor for long-term pain disability and pain chronicity, and is associated with higher rates of sick leave, pain vigilance, disability, and decreased physical activity.
“It has been demonstrated that kinesiophobia has shown to be a strong predictor for pain disability and pain chronicity in the longer term [73] associated with higher rates of sick-leaves [74], pain vigilance and disability as well as decreased physical activity levels [75–77].”
From Chronic pain and sex-differences; women accept and move, while men feel blue (2017) · cites this paper as [74]

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Buchbinder, R., Gross, D. P., Werner, E. L., & Hayden, J. A. (2008) · Spine · doi:10.1097/brs.0b013e31815e39c8 · Cited by 62 · see citing works
Fear-Avoidance Beliefs, Disability, and Participation in Workers and Nonworkers With Acute Low Back Pain
Swinkels-Meewisse, I., Roelofs, J., Verbeek, A. L. M., Oostendorp, R. A. B., & Vlaeyen, J. W. S. (2005) · Clinical Journal of Pain · doi:10.1097/01.ajp.0000148626.84874.93 · Cited by 60 · see citing works
Back Pain
NACHEMSON, A. L. (1999) · International Journal of Law and Psychiatry · doi:10.1016/s0160-2527(99)00022-9 · Cited by 59 · see citing works
Individuals with low back pain: how do they view physical activity?
Keen, S., Dowell, A. C., Hurst, K. M., Moffett, J. A. K., Tovey, P., & Williams, R. (1999) · Family Practice · doi:10.1093/fampra/16.1.39 · Cited by 56 · see citing works
Measures in Chiropractic Research: Choosing Patient-Based Outcome Assessments
Khorsan, R., Coulter, I. D., Hawk, C., & Choate, C. G. (2008) · Journal of Manipulative and Physiological Therapeutics · doi:10.1016/j.jmpt.2008.04.007 · Cited by 57 · see citing works
The Association Between Beliefs About Low Back Pain and Work Presenteeism
Mannion, A. F., Horisberger, B., Eisenring, C., Tamcan, Ö., Elfering, A., & Müller, U. (2009) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0b013e3181beac69 · Cited by 54 · see citing works
Self‐management education en masse: effectiveness of the Back Pain: Don’t Take It Lying Down mass media campaign
Buchbinder, R. (2008) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.2008.tb02207.x · Cited by 54 · see citing works
Low back pain in adolescent female rowers: a multi‐dimensional intervention study
Perich, D., Burnett, A., O’Sullivan, P., & Perkin, C. (2010) · Knee Surgery Sports Traumatology Arthroscopy · doi:10.1007/s00167-010-1173-6 · Cited by 53 · see citing works
“This questionnaire has been found to be suitable for patients with LBP and also for workers with and without LBP [ 45 , 46].”
Background
Discrepancy Between Disability and the Severity of Low Back Pain: Demographic, Psychologic, and Employment-Related Factors
Takahashi, N., Kikuchi, S., Konno, S., Morita, S., Suzukamo, Y., Green, J., & Fukuhara, S. (2006) · Spine · doi:10.1097/01.brs.0000209319.94256.89 · Cited by 52 · see citing works
“We used data from a representative sample of the population of Japan to study discrepancies between pain and disability in people with LBP.”
MethodInfluential
Low Back Pain Among Medical Students
Amelot, A., Mathon, B., Haddad, R., et al. (2019) · Spine · doi:10.1097/brs.0000000000003067 · Cited by 50 · see citing works
The efficacy of targeted interventions for modifiable psychosocial risk factors of persistent nonspecific low back pain – A systematic review
Kent, P. M., & Kjær, P. (2012) · Manual Therapy · doi:10.1016/j.math.2012.02.008 · Cited by 47 · see citing works
Ten weeks of physical-cognitive-mindfulness training reduces fear-avoidance beliefs about work-related activity
Jay, K., Brandt, M., Jakobsen, M. D., Sundstrup, E., Berthelsen, K. G., schraefel, M. C., Sjøgaard, G., & Andersen, L. L. (2016) · Medicine · doi:10.1097/md.0000000000003945 · Cited by 48 · see citing works
UK Back pain Exercise And Manipulation (UK BEAM) trial – national randomised trial of physical treatments for back pain in primary care: objectives, design and interventions [ISRCTN32683578]
UK Back pain Exercise And Manipulation (UK BEAM) Trial Team (2003) · BMC Health Services Research · doi:10.1186/1472-6963-3-16 · Cited by 44 · see citing works
Un simple livret d'information peut contribuer à réduire l'incapacité fonctionnelle de patients lombalgiques subaigus et chroniques. Étude contrôlée randomisée en milieu de rééducation
Coudeyre, E., Givron, P., Vanbiervliet, W., Benaïm, C., Hérisson, C., Pelissier, J. Y., & Poiraudeau, S. (2006) · Annales de Réadaptation et de Médecine Physique · doi:10.1016/j.annrmp.2006.05.003 · Cited by 52 · see citing works
Implementing Evidence-Informed Policy into Practice for Health Care Professionals Managing People with Low Back Pain in Australian Rural Settings: A Preliminary Prospective Single-Cohort Study
Slater, H., Briggs, A. M., Smith, A. J., Bunzli, S., Davies, S., & Quintner, J. L. (2014) · Pain Medicine · doi:10.1111/pme.12351 · Cited by 42 · see citing works
Fear of movement/(re)injury in Chinese patients with chronic pain: Factorial validity of the Chinese version of the Tampa Scale for Kinesiophobia
Wong, W., Kwok, H. H. Y., Luk, K., Chow, Y., Mak, K., Tam, B., Wong, E., & Fielding, R. (2010) · Journal of Rehabilitation Medicine · doi:10.2340/16501977-0575 · Cited by 42 · see citing works
“Conversely, a number of intervention studies show that lowering pain-related fear is associated with reduced work absence (12) and compensation costs (13), improved functional abilities (14, 15) and increased physical activity levels (16).”
Background
Back Pain Beliefs Are Related to the Impact of Low Back Pain in 17-Year-Olds
Smith, A. J., O’Sullivan, P., Beales, D. J., & Straker, L. M. (2012) · Physical Therapy · doi:10.2522/ptj.20110396 · Cited by 41 · see citing works
Is ergonomic intervention alone sufficient to limit musculoskeletal problems in nurses?
Burton, K. A., Symonds, T. L., Zinzen, E., Tillotson, K. M., Caboor, D., Roy, P. V., & Clarys, J. P. (1997) · Occupational Medicine · doi:10.1093/occmed/47.1.25 · Cited by 41 · see citing works
Self-citation
Are Psychosocial Factors Associated With Low Back Pain and Work Absence for Low Back Pain in an Occupational Cohort?
Urquhart, D. M., Kelsall, H. L., Hoe, V. C. W., Cicuttini, F., Forbes, A. B., & Sim, M. R. (2013) · Clinical Journal of Pain · doi:10.1097/ajp.0b013e31827ff0c0 · Cited by 40 · see citing works
Rationale, design, and protocol for the prevention of low back pain in the military (POLM) trial (NCT00373009)
George, S. Z., Childs, J. D., Teyhen, D. S., Wu, S. S., Wright, A. C., Dugan, J. L., & Robinson, M. E. (2007) · BMC Musculoskeletal Disorders · doi:10.1186/1471-2474-8-92 · Cited by 40 · see citing works
Pain‐related fear at the start of a new low back pain episode
Sieben, J. M., Portegijs, P. J. M., Vlaeyen, J. W. S., & Knottnerus, J. A. (2005) · European Journal of Pain · doi:10.1016/j.ejpain.2004.12.007 · Cited by 40 · see citing works
The Experience of Low Back Pain in Iranian Women: A Focus Group Study
Tavafian, S. S., Gregory, D., & Montazeri, A. (2008) · Health Care For Women International · doi:10.1080/07399330701876356 · Cited by 39 · see citing works
Physical Therapist Management of a Patient With Acute Low Back Pain and Elevated Fear-Avoidance Beliefs
George, S. Z., Bialosky, J. E., & Fritz, J. M. (2004) · Physical Therapy · doi:10.1093/ptj/84.6.538 · Cited by 38 · see citing works
Effect of Peer-Based Low Back Pain Information and Reassurance at the Workplace on Sick Leave: A Cluster Randomized Trial
Odéen, M., Ihlebæk, C., Indahl, A., Wormgoor, M. E. A., Lie, S. A., & Eriksen, H. R. (2013) · Journal of Occupational Rehabilitation · doi:10.1007/s10926-013-9451-z · Cited by 37 · see citing works
“An educational pamphlet on advice and reasons to stay active showed promising results [42], and a non-randomized study of the precursor to the atWork intervention also had a significant effect on sick leave [23], as did an integrated care approach [43].”
Background
Back pain beliefs among physiotherapists are more positive after biopsychosocially orientated workshops
O’Sullivan, K., O’Sullivan, P., O'Sullivan, L. W., & Dankaerts, W. (2013) · Physiotherapy Practice and Research · doi:10.3233/ppr-2012-0012 · Cited by 35 · see citing works
Beliefs About Back Pain
Bowey, J., Davis, S., Purcell‐Jones, G., & Watson, P. (2010) · Clinical Journal of Pain · doi:10.1097/ajp.0b013e3181ffc00b · Cited by 34 · see citing works
Management of musculoskeletal pain in a compensable environment: Implementation of helpful and unhelpful Models of Care in supporting recovery and return to work
Beales, D. J., Fried, K., Nicholas, M. K., Blyth, F., Finniss, D. G., & Moseley, G. L. (2016) · Best Practice & Research Clinical Rheumatology · doi:10.1016/j.berh.2016.08.011 · Cited by 34 · see citing works
Impact de programmes de restauration fonctionnelle sur les peurs, croyances et conduites d’évitement du lombalgique chronique
Chaory, K., Rannou, F., Fermanian, J., et al. (2004) · Annales de Réadaptation et de Médecine Physique · doi:10.1016/j.annrmp.2003.10.007 · Cited by 32 · see citing works
Development of a Pain and Discomfort Module for Use with the WHOQOL-100
Mason, V. L., Skevington, S. M., & Osborn, M. (2004) · Quality of Life Research · doi:10.1023/b:qure.0000031344.53009.eb · Cited by 32 · see citing works
Traduction française et adaptation culturelle du « back book »
Coudeyre, E., Givron, P., Grémeaux, V., Lavit, P., Hérisson, C., Combe, B. G., Burton, K. A., & Poiraudeau, S. (2003) · Annales de Réadaptation et de Médecine Physique · doi:10.1016/j.annrmp.2003.02.001 · Cited by 31 · see citing works
Self-citation
Negative beliefs about low back pain are associated with persistent high intensity low back pain
Ng, S. K., Cicuttini, F., Wang, Y., Wluka, A. E., Fitzgibbon, B. M., & Urquhart, D. M. (2016) · Psychology Health & Medicine · doi:10.1080/13548506.2016.1220602 · Cited by 30 · see citing works
“The questionnaire has been reported to have good internal consistency (Cronbach = .7) and test–retest reliability (ICC = .87; Symonds et al., 1995).”
Background

Authors: Symonds, T. L., Burton, A. K., Tillotson, K. M., & Main, C. J.
Affiliations: University of Huddersfield (GB)
Salford Royal NHS Foundation Trust (GB)
Corresponding author: Symonds, Tara L.
Tillotson, K. Malcolm
ORCID: Symonds, Tara L.
Main, Chris J.
Venue: Spine
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1995-12
Volume: 20
Issue: 24
Pages: 2738-2745
ISSN: 0362-2436 (ISSN-L)
DOI: 10.1097/00007632-199512150-00016
OpenAlex: W2080043403
Cited by: 193
References: 0
Citations by year: 2026: 1 · 2025: 2 · 2022: 1 · 2021: 4 · 2020: 1 · 2019: 4 · 2018: 2 · 2017: 5 · 2016: 6 · 2015: 6 · 2014: 6 · 2013: 8 · 2012: 8
FWCI: 3.56
Type: journal article
Language: en
Open access: closed
Locations: Spine (publishedVersion)
PubMed (publishedVersion)
University of Huddersfield Repository (University of Huddersfield) (submittedVersion)
Huddersfield Research Portal (University of Huddersfield) (submittedVersion)
Topics: Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
Keywords: low back pain, absenteeism, psychosocial interventions, health education leaflets, avoidance behavior, pain beliefs, locus of control, work loss, industrial workers, chronic pain
MeSH terms: Absenteeism, Adult, Fear, Health Surveys, Humans, Pamphlets, Surveys and Questionnaires, Social Support, Time Factors, Work, Low Back Pain, Workplace

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Absence resulting from low back trouble can be reduced by psychosocial intervention at the work place

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