The physiotherapist’s role in occupational rehabilitation Background

For most people work is a key determinant of self-worth, family esteem, identity and standing within the community, in addition to material wealth, level of social participation and fulfilment and ability to maintain a chosen lifestyle. Without fulfilling work people may not achieve their potential at the expense of themselves, their families and their communities. Recently, work has also been confirmed to be of great importance to an individual’s health and wellbeing. 1, 2 As our population ages and our recognised skills shortage grows it is becoming increasingly important to ensure that employees are not affected by chronic injury or illness. Many of the common disorders that physiotherapists treat are preventable to a great extent. Work design, education, training, early intervention where injury does occur and appropriate health supervision are some of the ways we can deal with reducing the incidence and impact of injury and illness to workers. In this way, physiotherapists play a key role in extending and optimising the productive working lives of Australian adults. Pain and disability in working age people is a primary contributor to Australia’s significant health burden. During the period 2008/2009 NSW WorkCover claims payments totalled $2,525 million. 3 These direct costs represent the “tip of the iceberg”. Indirect injury costs related to lost productivity and health service usage increase this figure by an estimated 5 to 8 times. 4 Work-related injury or illness may arise from a range of conditions with global impact, much of which increases with age. The most prevalent injuries are musculoskeletal disorders, particularly disorders of the lower back, which represent the largest category of workers compensation claims. 5 The majority of costs attributed to back pain are associated with a small number of back pain sufferers who develop chronic pain and disability. 6 Workers with persisting difficulties in returning to work following musculoskeletal disorders are at risk of permanent disability once they have been off work for three to six months