Complete Back Care Programme Wiltshire and Swindon Sport working in partnership with Tri4Fitness and Total Rehab Solutions
What is the true impact of back pain ……. and how can we help….. Back pain can have significant impact on both physiological and psychological health, and effects the quality of the individual’s relationships with family and others. In wider context, more than 1 billion pounds of public money is spent by the health service each year on costs relating to back pain, and further £565 million in private healthcare (international association for the study of pain- Nikolas Maniadakis and Grey 2000) The Confederation of British industry (CBI) and Chartered institute for personnel and Development (CIPD) estimate the chronic low back pain (more than 6 weeks) related disability cost £434 per year per employee (2001) It should also be recognised that costs do not just relate to absenteeism, but also to the decreased performance while at work (Stewart et al, 2003) The 2005/2006 Health Executive figures indicated that 3.7 million working days were lost as a result of back pain. (Anderson, 1999) All employers have a responsibility to care for their employees and we can work with you to develop a Complete Back Care Management programme to enable your employees to remain in work or helped to make an earlier return to work and ultimately be more productive. We can offer advice for employers and help you to comply with your legal requirements and minimise the risk to your employees of developing back pain or making existing back pain worse. Evidence shows that good industrial relations, job satisfaction and partnership between employers and employees are key elements in the successful management of back pain problems. It may also help you to retain skilled and loyal staff. We can offer advice for workers to help them to understand the causes of back pain and give advice on what to do if you are a sufferer. Knowing what the risks are can help them to reduce the possibility of developing back pain. Most back pain is not caused by any serious damage or disease. The pain usually improves within a few weeks, at least enough to allow you to get on with your life. Suffering from back pain does not mean you must automatically be off work. Inactivity and bed rest can increase the chance of disability so it is in your interest to remain active unless your doctor tells you not to. There are things that your employer can do to help you stay in work or return to work. Registering with our 6 weeks exercise programme specifically designed to rehabilitate back pain sufferers through exercise. There is evidence that there are benefits to be gained through investing in effective sickness absence management. This is where we can help you develop a Complete Back Care Management programme for employees.
The best way to deal with back pain is to stay active and continue doing regular exercise. “The advice given 20 years ago was to rest, but research has shown that inactivity only makes things worse,” says Dries Hettinga of BackCare, a charity that offers support and information to people with back pain. “When you’re in pain you may want to stay in bed and not move around, but that leads to further loss of mobility and will only prolong the pain.” Staying active means continuing with regular day-to-day activities to avoid becoming sedentary. Examples include walking to the shops rather than taking the car, getting off the bus one stop early, gardening and taking the dog for a walk. The National Institute for Health and Care Excellence (NICE) guidelines put exercise at the heart of managing low back pain.
Yoga and other exercises If your back pain is mild, try to exercise as well as maintaining an active lifestyle. You can do any activity that gives your body a good workout. There's some evidence that regular Yoga practice is beneficial for people with high blood pressure, heart disease, aches and pains, including low back pain, depression and stress. There's also some research to show that Pilates can provide pain relief to people with non-specific low back pain. Ideally, your choice of activities should involve elements of endurance, as well as strength and flexibility. Examples include walking, running or jogging, cycling, dancing, swimming, hydrotherapy (exercising in water) and aqua aerobics.
Manual therapy Hettinga suggests combining an exercise programme with a course of manual therapy, especially when the pain is persistent. Manual therapy is provided by physiotherapists. Evidence suggests manual therapies can be effective. Your back is examined to see if any joints need to be freed up. They can do it with a gentle massage, mobilisation or manipulation. It’s especially helpful if your back is stiff and flexibility is an issue. There is always something that can be done about back pain, but it requires some work and dedication from the sufferer and support from their employer.
The link between Depression and Chronic Back Pain - By William W. Deardorff, PhD, ABPP For quite some time, clinical researchers have known that chronic back pain can lead to major depression. Newer studies are now looking at how psychological variables such as depression and anxiety may be linked to the onset of a back pain problem. Depression is by far the most common emotion associated with chronic back pain. The type of depression that often accompanies chronic pain is referred to as major depression or clinical depression. This type of depression goes beyond what would be considered normal sadness or feeling "down for a few days". The symptoms of a major depression occur daily for at least two weeks and include at least 5 of the following (DSM-IV, 1994):
A predominant mood that is depressed, sad, blue, hopeless, low, or irritable, which may include periodic crying spells Poor appetite or significant weight loss or increased appetite or weight gain Sleep problem of either too much (hypersomnia) or too little (hyposomnia) sleep Feeling agitated (restless) or sluggish (low energy or fatigue) Loss of interest or pleasure in usual activities Decreased sex drive Feeling of worthlessness and/or guilt Problems with concentration or memory Thoughts of death, suicide, or wishing to be dead
Chronic pain and depression are two of the most common health problems that health professionals encounter, yet only a handful of studies have investigated the relationship between these conditions in the general population (Currie and Wang, 2004). Major depression is thought to be four times greater in people with chronic back pain than in the general population (Sullivan, Reesor, Mikail & Fisher, 1992). In research studies on depression in chronic low back pain patients seeking treatment at pain clinics, prevalence rates are even higher. 32 to 82 percent of patients show some type of depression or depressive problem, with an average of 62 percent (Sinel, Deardorff & Goldstein, 1996). In a recent study it was found that the rate of major depression increased in a linear fashion with greater pain severity (Currie and Wang, 2004). It was also found that the combination of chronic back pain and depression was associated with greater disability than either depression or chronic back pain alone.
With this clear evidence we need to be aware of treating the whole person and not just concentrating on back pain alone. We have therefore partnered with professionals in not only back rehabilitation but also joined with the physiotherapist and a councillor to deal with any psychological issues that the sufferer may be dealing with. To explain who is involved in this Complete Back Care Management programme and why they want to support people suffering from back pain.
Andy Collins from Tri4Fitness My experience within the fitness industry started in 1995 and have continually developed my knowledge and skills ever since. I am currently at Practitioner level with CIMSPA and Level 4 Reps with most recent qualifications in Level 4 Low back management, Level 4 BACPR Cardiac Rehab, Level 3 Education and training award, Level 3-4 GP referral and Pilates. My day to day role is to run a successful personal training business, several classes and GP referral appointments at a local leisure centre. After suffering a serious back injury in a car accident in 2001, I was very disappointed with the aftercare and treatment I received. I still wanted to return to the active lifestyle I had before the accident and was determined to create my own care package to help myself regain my fitness. It consists of 2x week mobility, flexibility, core based Pilates, 2x week strength based training and 3x week cycling training which is my main passion leading to a 3 day cycling challenge in Italy this year. Finally and most importantly I am a family man with a young son and nothing pleases me more than spend quality time with them which none of this would be possible if I did not look after my health. My aim is to use my experience of injury rehabilitation and the effects on the person both Physical and Psychological to help others reduce pain and fulfil their potential in life. Link to an article about Andy and his accident - http://bit.ly/2jHxZ2
Odette Morris I have worked with and supported adults and young people with different needs for more than 20 years now both physically and emotionally. After working for a mental health charity called MIND where I was a Befriending Co-ordinator I presently run courses in mental health First Aid and Wellbeing sessions for groups of people from different organisations. I also do some one to one work with people supporting them with different emotional needs such as anxiety, depression or maybe something a bit more extreme! I help people to recognise and understand the symptoms they may be experiencing and then learn some coping strategies so that they can survive in this high pressured world we live in!
Joanne Carp from Total Rehab Solutions Joanna has been working as a physiotherapist in both Australia and the UK since she qualified in 2001. Joanna works in private practice in Trowbridge, working with people with a variety of musculoskeletal conditions. She describes herself as a Manual Therapist, using hands-on techniques as well as rehabilitation exercises to assist clients in their recovery. Joanna has a lot of experience in working with people with lower back pain, whether it’s a new injury, or something that’s been around for years. She is also qualified in the provision of Clinical Pilates to enhance recovery from injury and prevent any further issues recurring.
Leoni Van Haver our Cognitive Behavioural Therapist My background in work and study is in Marketing and Human Resources. Shortly after moving to the London area I took a long break raising my two lovely daughters. When my youngest started school I worked for many years as a self-employed consultant supporting people in achieving their weight loss goals. Doing this work made me realise how many people are struggling to change their behaviour towards food and exercise. Losing weight was the easy part; helping to develop an altered mind-set towards healthy eating and living proved much more of a challenge. As a result I became more and more interested in the psychology of the human mind and after obtaining level 2 and level 3 counselling certificates I decided to re-train as an integrative counsellor at Worcester University. Integrative means I work with a variety of approaches, one of which is Cognitive Behavioural Therapy. CBT is a proven way of working with clients to create positive change in areas of life where one can feel ‘stuck’. It can help to conquer anxiety, reduce stress, to break down unhealthy thinking patterns and to create new ways of ‘being’ which can be life transforming.
from Total Rehab Solutions
Having been diagnosed with a back problem at a young age I have experienced the challenges of ‘managing’ my condition being in school, the work place and with day to day living. Having Andy as my personal trainer has been key in motivating and inspiring me to achieve overall fitness -gaining strength and confidence in the process and he encouraged me to take part in his back-care programme. I am a member of the British Association for Psychotherapy and Counselling and adhere to their professional conduct procedures and ethical framework.
Kirsty Brown from Wiltshire and Swindon Sport I work for your County Sports Partnership (CSP) called Wiltshire and Swindon Sport (WASP). We administer the Sport England projects locally and support Clubs, Coaches, Schools and any organisation or individual that is involved with Sport or Physical Activity. Companies and organisations across Wiltshire and Swindon are invited to take part in the 'Workplace Challenge'. The aim of the programme is to promote sport, physical activity and health improvements across the UK's workplaces. Our Activity Log is used to record employee’s levels of sport, physical activity and active travel online and compete with other workplaces at the same time. You can log activities all year round for your own records, and many CSPs will be organising mini logging challenges across the year. We can also offer Competition Programme across a variety of sports for you and your colleagues.
from Total Rehab Solutions
It doesn't matter if you haven't played before, local sports coaches will provide support and instruction for your team and all events have an emphasis on fun.
The Workplace Challenge can benefit your workplace in the following ways
Workplace physical activity programmes can reduce absenteeism due to sickness, increase work attendance, reduce job stress and decrease healthcare utilisation Our dedicated network of 45 County Sports Partnerships are available to provide support, guidance and opportunities for workplaces to engage in sport and physical activity. Healthier and more active workplaces have been proven to be happier and more productive workforces. Research suggests that exercise can reduce absenteeism by 23.5% and staff turnover can be reduced by 16% (BUPA, 2015). Our software monitors "active travel" by recording how much C02 our users save by not driving to meetings, work, shops. etc.
Complete Back Care Programme What we are offering: We have a well organised specialist assessment and referral system using our partners in personal training, mental health, emotional wellbeing and physiotherapy.
1. Initial 1:1 Assessment Assess the individual employee to look into why they may be suffering from back pain. Assessing their posture, hips, back, pelvic tilt etc
2. Establish risk factors Recognise the risk factors that may be contributing to the back pain and deciding what exercises will help build strength back up in particular muscles that may not have been used and rectify any imbalances in the body.
3. 6 Weeks of exercise sessions The session plan is designed for gradual progression and not all the exercises will be introduced in the first week. This will be monitored with RPE scales, pain scale and at the start a readiness questionnaire to engage with the client and a comments box after the session. The aim of the six weeks sessions plan is to establish the start to improving posture, motor skill, imbalances and energy expenditures due from over working muscles. Long term the client will hope to see some reduce back pain to help with the balance of quality life and lifestyle. This will only work with a balanced diet combine with a structured exercise plan.
4. Psychological support As we recognise the correlation with physical symptoms and psychological effects of back pain we will assess the risk factor for depression and need for psychological support. Treating the wellbeing of the whole person is essential if no the back pain may return.
Why are we offering this Complete Back Care Management programme? Benefits to Employer
Benefits to Employee
Staff welfare
Reduce risk of back pain worsening
Productivity
Staying in work / employment
Bottom line £
Reduce pain and discomfort
Reduced sickness
Normal functional living
Reduced occupational health referrals
Self-esteem and confidence
Prevention of condition worsening
May feel ‘stuck in a rut’ and depressed
Retention of good staff
Coping mechanism
Video of our recent customer experiences of the Complete Back Care Management programme -
https://youtu.be/A0ppSja0HXA
Programme Process: Cognitive Behavioural therapist (CBT) Protocol Upon assessment by the back clinic expert/trainer, the outcome may show that there is an indication of the employee not being able to engage in the back clinic programme because of fears or anxieties related to his/her back problems. The proposed next step would be an initial consultation with a Cognitive Behavioural therapist. In this 60-minute session an assessment will be made of the employees’ issues in relation to the back clinic programme and to gauge willingness to engage in a process of change. Furthermore the employee will learn what to expect of the process and the methods used and have the opportunity to ask any questions they may have.
If the employee is willing and ready to engage in subsequent sessions, the therapist will draw up an initial plan of action and five subsequent weekly appointments (45 minutes each) will be scheduled. In these sessions the employees possible fears, anxieties or mental barriers will be identified further and suitable strategies will be suggested in order to get the employee mentally ‘ready’ to participate in either one-to-one or a group-led back clinic. There is some home-work involved and the employee will need to keep a diary which should take no more than 1-2 hours a week. Physio Protocol Upon assessment by the back clinic expert/trainer, the outcome may indicate the employee is not yet able to engage in the back care program, indicated by our screening tool, the Functional Movement Scale. This will highlight a need for physiotherapy referral for a more detailed assessment and treatment. Following this Initial Assessment, there would be 5 treatment sessions including manual therapy, provision of appropriate exercises and education. This would include a Pain Fundamentals Education and Treatment Workbook with the most up-to-date Pain Science information. If there is any indication of more serious medical issues, the client will be Red Flagged and the physiotherapist would refer the client directly back to the GP.
Back Care exercise programme
Pre Mobility exercises Specific Posture, flexibility, mobility exercises Specific Core exercises Specific Coordination/Balance exercises Specific Strength exercises Specific Flexibility exercises
After the 6 weeks each employee meets with the instructor to record overall progress and the potential management of his or her low back care.
Complete Back Care Management Programme Costs: Package One - Full assessment and 6 weeks back care group sessions (minimum 4 people) - £60 Package Two - Full assessment and 6 weeks back care group sessions (minimum 4 people) plus 5 x CBT/Wellbeing session or Physio - £215 Package Three - Full assessment and 6 weeks back care group sessions (minimum 4 people) plus 5 x CBT/Wellbeing session and 5 Physio - £370
Health insurance: Bupa We see people with BUPA membership. They usually get 5 sessions covered - Initial Assessment and 4 x treatment sessions. Simply Health Anyone with Simply Health insurance usually pays for their physio, then they get reimbursed afterwards. Nuffield Health We also get referrals through Nuffield Health, they usually get a maximum of 6 sessions. Also we would send out a letter to their GP asking permission to medical conditions and expectance into the Back care scheme (please see attached form).
Assessments are by appointment with back specialist and physio or wellbeing consultant. Assessment and consultations are to be carried out at Total Rehab Solutions, Unit 1 Stone Mill, Court Street, Trowbridge, Wiltshire, BA14 8BU (Possibly in workplace if a private room can be provided) Assessments would be carried out during the working day and the exercise sessions will be on Wednesday afternoons 2.30 – 3.30pm unless we set up bespoke exercise sessions due to demand and to fit in with an employer.
Contact: Complete Back care Management Programme leader Andy Collins on 07905 558666 or email enquiry@tri4fitness.co.uk Workplace Challenge leader Kirsty Brown on 01225718500 or email kirsty@wiltssport.org.uk
Complete Back Care Programme Wiltshire and Swindon Sport working in partnership with Tri4Fitness and Total Rehab Solutions