Physio Charlie

Upper limb disorders Occupational aspects of management

This is a very up to date look at the evidence for the management of ULD's in the workplace.  As with a lot of research, the only good evidence they have found is that multidisiplinary treatment with a biopsychosocial approach for non specific arm pain and changing a keyboard for carpal tunnel are better than usual care.

I attended an Occupational health course on 30 sept - 2nd Oct 2009 run by Nicoloa Hunter and Amanda Jones.

It was very informative.  Things I learnt were:

1.  Occupational epidemiology - statistics relating to occupational health and musculoskeletal disorders, i.e. Nurses have statistically more back pain than many other professions.  In Lithuania whiplash does not exist as they have no compensation culture. NIOSH epidemiology of MSD's

2. Evidence based practice and LBP - there has been a republication of the NICE guidelines; non-specific low back pain that has lasted for more than 6 weeks, but for less than 12 months.  Back in work for NHS employes is also a good guide and has soem great assessment tools.  Functional restoration programmes are useful after 12/52 of LBP.  The OREBRO questionnaire is a good outcome measure, scoring. The OREBRO (ÖMPQ) is a ‘yellow flag’ screening tool that predicts long-term disability and failure to return to work when completed four to 12 weeks following a soft tissue injury2.  A cut-off score of 105 has been found to predict those who will recover (with 95 per cent accuracy), those who will have no further sick leave in the next six months (with 81 per cent accuracy), and those who will have long-term sick leave (with 67 per cent accuracy).

3. Evidence based practice and neck apin - there is no evidence for any clinical tests.  Level 1 evidence for advising incresed movement and reassurance.

4.  Confidentiality and consent - we must have the patient sign consent to discuss their problem with the occupational health dept.  We can document this in our notes.  The Disability Discrimination Act is important here.

I have a new website!!

http://physiocharlie.vpweb.co.uk

I read this on the iCSP website and thought it would be useful on Phased return to work and annual leave:

I work for an acute NHS trust and deal with all the MSK cases and return to work advice following a period of sickness absence. If a phased return to work is indicated with reduced hours the HR department's direction to line managers is that the affected member of staff should take their remaining hours out of their annual leave. Does anyone know what the relevant legislation or legal precident is regarding this matter? Do employees have to take annual leave as part of a phased return to work?
Title:  Phased return to work and annual leave Added by:  PHELANJMJ Posted:  08 September 2008 10:51 Hi I have a great deal of problems with this issue, both as a steward and as an Occupational Health physiotherapist. Usually local policies cover this with an "under managers discretion" clause. However the following reference may help. The Healthy Workplaces Handbook (2007). NHS Employers. Section 5, Chapter 43, Managing Sickness Absence Page 19 Second paragraph “Pay issues relating to the phased return to work will need to be decided locally, but it would seem reasonable that the patient should remain on full sick pay, if they are entitled to it, as they would be entitled to full pay at home.” Good luck. Jim