Chronic disability may be needlessly spine-chilling, says Neasa MacErlean.
Up to 500,000 back pain sufferers are thought to be out of the job market entirely and claiming Incapacity Benefit. Those that are in work cost employers �18 billion a year in time off. The Arthritis and Musculoskeletal Alliance (Arma), launches a campaign tomorrow arguing that much of this physical and financial suffering is unnecessary.
Arma is publishing a set of 'standards of care' for doctors and other health workers, since it believes 'the postcode lottery of the NHS means that a reasonable standard of care is unavailable for the vast majority of people with MSCs [musculoskeletal conditions]'.
Teresa Stella-Sawicka is one long-term back pain sufferer who believes that many people could continue to earn a wage and build up a pension if they were given simple advice, the correct physiotherapy, pain relief or other treatment. 'I am too far gone now to do a day's work,' she says of her painful condition, which includes leg pain and spasms and dates from 1996.
'But people beginning to go down this line - if they are caught early and given the right techniques to deal with the pain - could probably work either in an adapted workplace or part-time.'
Arma is concerned that far too many people believe the 'myth' that bed rest is the best cure when mobility is far better maintained by exercise.
All sorts of simple measures can keep people in a job - including better chairs; standing for intervals rather than sitting; learning a few lessons about posture and ergonomics; using a telephone headset instead of cradling a telephone handset in the neck; and working flexi-hours (to avoid travelling in crowded conditions).
Many people will, ironically, develop back problems because of their work. If you sit at a desk all day, you have a high chance of developing back pain at some point unless you exercise to get a strong and flexible back.
Sitting with your knee bent just an inch too far for your type of body will not hurt you for a day, but could cripple you in a few years. A significant minority of people could save themselves chronic knee problems by using foot rests.
Arma is not a voice crying in the wilderness. Government, employers and trade unions all recognise the scale of this problem, particularly in an ageing workforce.
Altogether, about 8.5 million people (about one in eight of the population) suffer from one of about 200 different MSCs. And since people are more likely to develop problems as they age, we could find we are not able to work the extra years that Adair Turner, chairman of the Pensions Commission, suggests we may need to.
The Department of Work and Pensions is now looking at 'vocational rehabilitation', trying to encourage employers and insurers to help people stay on at work. Secretary of State Alan Johnson has spoken out against the 'sick note culture' and may try to tackle the practice whereby some GPs willingly sign people off work but do little to help them understand their conditions or get better.
The Trades Union Congress has similar concerns. General secretary Brendan Barber says: 'Ill health and injury caused by work force thousands of employees to leave their jobs every year. Too many give up work completely because, although they may win compensation from employers, they don't get help getting fit for work.'
And the Disability Discrimination Act means employers must make 'reasonable adjustments' to the working process to help disabled people - including those with chronic MSCs, - work more easily.
A life on Incapacity Benefit (�74.15 a week at the long-term rate) has been the lot of the 40 per cent of rheumatoid arthritis sufferers who give up work within 10 years of diagnosis, according to Arma.
But it need not be so. New drugs for inflammatory arthritis, for instance, allow people to go back to work in a few weeks - but too few sufferers and their doctors are aware of this treatment. 'There are some fantastic [health service] practices out there, but they are not in the mainstream,' says Sophie Edwards, chief executive of Arma.
'Healthcare plays a key part in getting people back to work. But the longer you are off work, the less likely you are to get back.' The Observer