Returning to work after long term sickness absence due to low back pain – the struggle within: a qualitative study of the patient’s experience

Background: Low back pain (LBP) is a major cause of work absence. Assisting individuals back into work is an important part of rehabilitation. OBJECTIVE: To explore the experiences of individuals returning to work after an episode of sickness absence due to LBP. Participants: Five women employed by a UK University who had returned to work. Method: In this qualitative study, participants underwent semi-structured interviews about their experiences. The transcripts were analysed using interpretative phenomenological analysis. Results: Two primary themes emerged 1) perceived pressure to return to work and 2) strategies employed to relieve the pressure to return. Pressure to return to work arose from a number of sources including guilt and a personal work ethic, internally, and from colleagues and management, externally. This pressure led to the individual employing a number of strategies to reduce it. These ranged from a simple denial of health concerns and decision to return to work regardless of their condition, to placing the responsibility of the decision not to return to work onto a significant other, such as a family member or health care professional. Conclusions: Individuals returning to work with LBP experience considerable pressure to return and use a range of strategies to mediate that pressure.