‘You’re on your own’: the misery of being out of work with back pain
Jean Rice worked as a nurse and then a carer for more than 30 years until May last year, when she developed severe back and leg pain after helping to move a disabled woman in a wheelchair into a vehicle.
She has not been able to work since then. “It’s really sad because I love taking care of people,” said the 64-year-old. “I love making a difference in someone’s life with the smallest things, just by putting them at ease. I can’t do it anymore. I have to limit my activities, even walking, which I love.”
She is one of almost a million people now unable to do their work due to back or neck problems – an increase of more than a quarter since before the Covid pandemic.
Globally, low back pain is the leading cause of disability, according to the World Health Organization, which expects the number of cases to rise from 619 million in 2020 to 843 million in 2050 as the population ages.
Rice was eventually diagnosed with osteoporosis and osteoarthritis in her hips and lower back, which is exacerbated by physical activity. Rice is now trying to get by on less than £100 a week in universal credit. Initially she had statutory sick pay, worth £109.40 a week, but this is only paid for 28 weeks.
“I have to call my mortgage company and the utilities because I can’t afford anything,” she says. She is looking for another job that places fewer demands on her body. “I don’t want to give up my job,” she says, adding that the situation has affected her mental health.
Tony Wilson, director of the Institute for Employment Studies (IES), says the sharp increase in painful musculoskeletal conditions is “partly a reflection of the aging of the population. We now have many more people in their mid-forties to mid-fifties: they are the children of the baby boomers.”
It’s not just workers who do physical work, like Rice’s, who are increasingly suffering from back and neck problems. Shelly Asquith, the TUC’s health, safety and wellbeing spokesperson, said: “Musculoskeletal damage used to be associated with manual handling of highly physical tasks. He is increasingly hunched over a desk, and that has increased enormously now that people are working from home.”
Many workers were confined to their kitchen tables and spare bedrooms during the pandemic, with little support from their employers to ensure their workspace was suitable.
A survey conducted among office workers in mid-2020 shows this a project called Work After LockdownMore than 40% of respondents indicated that they had more musculoskeletal pain than normal.
Asquith suggests that the pressures of some screen-based jobs are also relevant. “There is a big problem with work intensification, where people are expected to do more with the time they have. We often focus on the stress impact of this, but there are also physical effects.” She underlines the responsibilities of employers to protect the health and safety of employees.
And while hybrid working offers new flexibility, it comes with risks. A city worker who suffers from chronic back pain said the flexible working culture isn’t helping.
“We used to have our own computers at work and laptops at home. Now they suddenly take away all the permanent computers,” says the woman in her thirties, who does not want to be named.
“If you want to work in the office, you have to carry your laptop, your mouse, your charger, everything. And your seat is not adjusted for you. That will have consequences.”
When her condition flares up, she has to work from home so she can take the occasional break to lie on the floor.
The rise in back and neck conditions is a key factor behind a rapid increase in the number of people claiming illness-related benefits: last year alone the Treasury paid out £1.4 billion in disability benefits related to back pain. But the real economic impact is much greater, as many affected end up leaving the workforce.
Andrew Phillips, a senior researcher at Demos who has studied the problem, says more people with chronic conditions could be enabled to stay in work, with the right support.
Demos found that increasing the proportion of 55-64 year olds working in Britain from the current 65% to Germany’s 75% would increase GDP by £30 billion.
Phillips pointed to the need for better access to occupational health care – which is widespread among larger employers but non-existent at many smaller companies – and supportive management.
He speaks to people suffering from chronic conditions about their experiences and adds: “One of the things that really stood out was the difference between people’s experiences of line management. A few people even said they didn’t really talk about their condition because they didn’t feel supported.”
This is in line with research from experts at the University of Southampton, published in the British Medical Journal, which found that job satisfaction is a key factor determining whether people with health problems leave paid work.
Wilson from the IES says: “Employers need to be aware of how they can support older people in general at work. A lot of this comes down to how we can make work better and better support good health.”
The Chancellor, Jeremy Hunt, has recognized the challenge of health-related inactivity and announced a range of measures, including a pilot project called Work Well, aimed at linking employment and healthcare.
A government spokesperson said: “We are committed to providing people with back, neck and other serious health problems with the support they need to find a job that suits them best.
“Our back-to-work plan will help an additional 1.1 million people with disabilities, those with long-term health conditions or the long-term unemployed to find and retain work.”
John Gessler, a 60-year-old from Barnsley who previously worked as a programmer, has a long-term back condition that has prevented him from working full-time for years.
“Nobody tells you how to be a patient; you are on your own,” he says. “Eventually I couldn’t work at all anymore. In the end I couldn’t even go to the employment office to register.” With chronic conditions like his, he says, “you have to go through different stages of grief because you’re waiting for a cure, and then your hopes are dashed.”
He benefited from an expert patient programme, offered by the NHS at the time, which helped him understand and manage his condition, including through physical activity. He subsequently became a teacher himself, which subsequently led to other roles. “It was a lifeline for me: I wasn’t working at the time,” he says.
The expert patient program is still running in some areas, but the charity that delivers it in many parts of Britain, Self Management UK, closed itself down last year, saying it had been “swimming against the NHS tide”.
Since he no longer works, Gessen manages his condition with the help of physical activity. “I walk the puppy for two, three or four hours a day: that is maintenance. I’m 60 years old and I can’t just bounce back.”
As someone who has worked with many patients with long-term health problems, he says employers need to consider how they can continue to benefit from experienced workers whose health limits their options.
“I would say: don’t regard illness in the workplace as an exception. It is going to happen. It must be anticipated. What is your policy to support them, not overwhelm them? Are you ready to turn someone into a mentor, instead of a keyboard warrior?