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Case 13: Low back injury caused by lifting, exacerbated by a trip

Company

Major multi-site bakery company

Background

This case study looks at the rehabilitation of an employee working in the despatch department at one of the company’s sites. The employee was employed as an order picker on 12 hours shifts on a rotation basis. He worked for the company for 6 years with an excellent attendance record. His general health was good and, apart from a 20-a-day smoking habit, he had no relevant lifestyle issues which impacted on his health. He was aged 36 years at the time of the injury.

Injury

An acute episode of low back pain prevented the employee from working for two weeks. He consulted his GP and was prescribed appropriate treatment; the problem subsided. He returned to work and his return to work interview revealed that, although he was much improved, his back was not fully recovered. As result he was allocated restricted duties and advised to take things carefully. Unfortunately a few hours after his return his foot slipped down a pothole and he jarred his back. This exacerbated his recovering back problem. As a consequence he was unable to continue work and was taken home by car in severe discomfort; he was unable to drive. 

The employee consulted his GP and was prescribed standard medication for an acute back problem: strong anti-inflammatory and muscle relaxant mediation. This episode was more acute than the previous episode and prevented him from sleeping, climbing stairs and generally restricted his daily activities.

He was referred to Occupational Health and, as he was unable to drive, a home visit with Human Resources was arranged.   During the visit it became evident that the problem was still very acute and that the employee would not be fit to return to his job for some time. His previous work history was in the building trade and he admitted to one previous episode of back problems following an injury at work some 8 years previously; this had been resolved quickly with the aid of physiotherapy. During the visit back care was discussed and a guidance booklet issued which contained the latest research information on how to treat back problems.  He was encouraged to keep as active as possible and, to aid his recovery, he agreed to be referred for physiotherapy funded by the company.

Rehabilitation plan

The employee was very keen to return to work as soon as he was mobile enough to drive but, on the advice of the physiotherapist, this was postponed until his back condition had stabilised.  He received a weekly physio appointment for 4 weeks and carried out prescribed exercises to aid his recovery.  He attended an occupational health review prior to his return and his manager joined the discussions so that a rehabilitation plan could be put into place.  It was agreed that on his return he would:

  • work reduced hours, initially working 6 hours per day and then increasing over 6 weeks to his full 12 hours shifts  
  • be supported by changing his work to a task with less  time pressure 
  • attend for a manual handing training course and be reassessed to ensure that he as applying good lifting techniques 
  • only lift one basket at a time, in order to reduce pressure on his back 
  • continue with the back exercise as recommended by the physiotherapist (he was now discharged from treatment).

Conclusion

Full rehabilitation back to his usual job took 8 weeks, following a sickness absence of 6 weeks.   The employee made a good recovery and indicated he found the provision of physiotherapy and the structured rehabilitation programme most helpful.  Otherwise he would have found it very difficulty to restrict his activities and the hours worked once he was back at work.  He continued with the exercises advised by the physiotherapist. He has yet to address his smoking habit that will also impact on back health.

Company policy on rehabilitation

The company is proactive in terms of rehabilitation.  The process usually involves a team approach involving the employee, Human Resources, the line manager, the health and safety co-ordinator, the employees GP / consultant, physiotherapist and the Occupational Health Practitioner. 

For less complex cases, the key to a safe return to work rests with the line manager. In particular strict adherence to the rule that an employee does not resume work until the return-to-work interview has been completed by the manager. This ensures the employee’s fitness to return is not compromised, and that health and safety are not put at risk.  As a result, adjustments to the employees work pattern are frequently put in place, as even after relativity minor illnesses such as flu it can take some time to recover fully.

More complex rehabilitation cases following longer absences are planned prior to return and a rehabilitation plan put in place. Such cases include the rehabilitation of  employees  following musculoskeletal problems, fractures,  recovery from heart attack, post viral debility etc.. Each case has to be assessed on an individual basis as no two cases are the same.  The process is similar whether the cause of the problem is job- related or not.

Link URLs in this page

  1. Food & drink manufacturehttps://www.hse.gov.uk/food/index.htm
  2. Common risks - in food and drink manufacturing industrieshttps://www.hse.gov.uk/food/industries.htm
  3. Meat, poultry and fishhttps://www.hse.gov.uk/food/slaughter.htm
  4. Milling, animal feedshttps://www.hse.gov.uk/food/grain.htm
  5. Bakery productshttps://www.hse.gov.uk/food/bakery.htm
  6. Dairy productshttps://www.hse.gov.uk/food/dairy.htm
  7. Fruit and vegetableshttps://www.hse.gov.uk/food/fruitveg.htm
  8. Alcoholic and soft drinkshttps://www.hse.gov.uk/food/drink.htm
  9. Chilled and frozen products https://www.hse.gov.uk/food/chilled.htm
  10. Supply chainhttps://www.hse.gov.uk/food/chain.htm
  11. Safety risks overviewhttps://www.hse.gov.uk/food/safety-hazards.htm
  12. Manual handlinghttps://www.hse.gov.uk/food/handling.htm
  13. Slips on wet or contaminated floorshttps://www.hse.gov.uk/food/slips.htm
  14. Falls from heighthttps://www.hse.gov.uk/food/falls.htm
  15. Workplace transporthttps://www.hse.gov.uk/food/transport.htm
  16. Struck by somethinghttps://www.hse.gov.uk/food/struckby.htm
  17. Overview - Food processing machineryhttps://www.hse.gov.uk/food/machinery.htm
  18. European CEN 'C' Standards for food processing machineshttps://www.hse.gov.uk/food/standards.htm
  19. Packaging machineryhttps://www.hse.gov.uk/food/package.htm
  20. Overview - Prevention of dust explosionshttps://www.hse.gov.uk/food/dustexplosion.htm
  21. Selection and use of vacuum cleanershttps://www.hse.gov.uk/food/dustexplosionapp1.htm
  22. Explosion relief for small bins and siloshttps://www.hse.gov.uk/food/dustexplosionapp2.htm
  23. Overview - Occupational health topicshttps://www.hse.gov.uk/food/healthtopics.htm
  24. Musculoskeletal disorders (MSDs)https://www.hse.gov.uk/food/musculoskeletal.htm
  25. Dermatitishttps://www.hse.gov.uk/food/dermatitis.htm
  26. Noise induced hearing losshttps://www.hse.gov.uk/food/noise.htm
  27. Overviewhttps://www.hse.gov.uk/food/asthma.htm
  28. Low dust flourhttps://www.hse.gov.uk/food/low-flour-dust.htm
  29. Exposure to disinfectantshttps://www.hse.gov.uk/food/disinfectants.htm
  30. Work-related stresshttps://www.hse.gov.uk/food/stress.htm
  31. Overview - Occupational rehabilitationhttps://www.hse.gov.uk/food/rehabilitation/index.htm
  32. OH Case studieshttps://www.hse.gov.uk/food/rehabilitation/casestudies.htm
  33. Overview - Resourceshttps://www.hse.gov.uk/food/information.htm
  34. Case studieshttps://www.hse.gov.uk/food/experience.htm
  35. Useful linkshttps://www.hse.gov.uk/food/links.htm
  36. Food and Drink Manufacture Health and Safety Forumhttps://www.hse.gov.uk/food/forum.htm
  37. Topics of interesthttps://www.hse.gov.uk/food/live.htm
  38. Case studies menuhttps://www.hse.gov.uk/food/rehabilitation/casestudies.htm
  39. Previous case studyhttps://www.hse.gov.uk/food/rehabilitation/case12.htm
  40. Next case studyhttps://www.hse.gov.uk/food/rehabilitation/case14.htm
  41. A recipe for safety: Occupational health and safety in food and drink manufacturehttps://www.hse.gov.uk/pubns/books/hsg252.htm
  42. Moving food and drink: Manual handling solutions for the food and drink industries https://www.hse.gov.uk/pubns/books/hsg196.htm
  43. Case studieshttps://www.hse.gov.uk/food/experience.htm
  44. Food Standards Agencyhttps://www.food.gov.uk/
  45. Slips and tripshttps://www.hse.gov.uk/slips/index.htm
  46. Fallshttps://www.hse.gov.uk/work-at-height/index.htm
  47. Musculoskeletal disordershttps://www.hse.gov.uk/msd/index.htm
  48. Workplace transport micrositehttps://www.hse.gov.uk/workplacetransport/index.htm
  49. Equipment at workhttps://www.hse.gov.uk/work-equipment-machinery/index.htm
  50. Back painhttps://www.hse.gov.uk/msd/backpain/index.htm
  51. Pushing and pullinghttps://www.hse.gov.uk/msd/pushpull/index.htm
  52. MAC toolhttps://www.hse.gov.uk/msd/mac/index.htm
  53. Food and Drink Manufacturing Forumhttps://www.hse.gov.uk/food/forum.htm
  54. Federation of Bakers (FoB)https://www.fob.uk.com/
  55. Craft Bakers Associationhttps://www.craftbakersassociation.co.uk/
  56. British Meat Processors Association (BMPA)https://britishmeatindustry.org/
  57. Dairy UKhttps://www.dairyuk.org/
  58. Chilled Foods Association (CFA)https://www.chilledfood.org/
  59. British Frozen Food Federation (BFFF)https://www.bfff.co.uk/
  60. Food Standards Agencyhttps://www.food.gov.uk/
  61. IOSH Food and Drink Grouphttps://www.iosh.co.uk/groups/food_and_drink_group.aspx

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Updated 2023-06-15