As physiotherapists we see many people who are unable to work for a period of time as a consequence of illness or injury. Most will get back to work within a week or two, but a number will not. We all inherently understand that there are benefits, apart from the obvious ones, in working. However there is a growing body of evidence to illustrate just how important work is in effects on health, and how grim the long term outlook may be for those who are out of the workforce for even a relatively short period of time.
Work does a whole lot more than provide us with a weekly pay packet. Work provides us with a sense of self-worth and identity, provides esteem from family and provides social contact. Many of us dream of having the free time to do all those other things we never seem to have time to do, or simply to have the time to do nothing. The reality is that the novelty of all that free time wears off very quickly and people become bored and frustrated. More importantly, research evidence shows that prolonged rest from work can delay recovery from an injury, increase the risk of chronic pain and increase the risk of adverse consequences as a result of prolonged inactivity.
Consider these statistics: a person off work for 20 days has only a 70% chance of returning to work, at 45 days the chance drops to 50%, and for those off work for 70 days there is only a 35% chance of returning to work.
The health effects of not working for prolonged periods are also frightening. There is an association between unemployment and poorer general health. Several studies have equated the negative health impact of not working as being equivalent to smoking 10 packets of cigarettes per day, and may have more consequence on life expectancy than cardiovascular disease or cancer.
In light of this evidence there is a move to educate all of those involved in getting injured people back to work. This involves collaboration between doctors, other health care providers, employers and the worker. Health care professionals have not always recognised the negative impact of having people off work. This is not to say that time off may not be necessary, but we now know that it is in the patient’s best interest to get back to some degree of work, perhaps with fewer hours and/or with alternative duties, as quickly as possible. It is in nobody’s interest to wait until you are 100% fully fit before getting back to work.
With acknowledgements from the ACC website, and The New Zealand Listener-“ The Time-Off Trap” May 2011.
Michelle Sintmaartensdyk is a physiotherapist at the Oamaru Physiotherapy Clinic. She has postgraduate qualifications in Manipulative Physiotherapy, Sports Medicine and is a Registered Physiotherapy Acupuncturist.