Occupational Health Physiotherapy Report to Manager

PRIVATE & CONFIDENTIAL Thank you for referring this employee to Occupational Health Physiotherapy. I undertook an assessment today regarding the content of your referral. Advice has been sought about fitness to work, with time frames and any suggestions for support, adjustments or restrictions that management could consider. We discussed her health in detail and Ms. Eleanor Vance is a 34-year-old administrative assistant who presented with chronic lower back pain exacerbated by prolonged sitting and lifting, ongoing for the past 6 months. She has a history of mild disc protrusion at L4/L5 confirmed by MRI 3 months ago. She has completed a previous course of physiotherapy but experienced a relapse after returning to full duties without modifications. The condition causes her to have symptoms of: * Dull, aching pain in the lumbar region, rating 6/10 at its worst. * Intermittent sharp pain radiating to the left gluteal area with certain movements. * Morning stiffness lasting approximately 30 minutes. * Difficulty concentrating due to persistent discomfort. From a functional perspective they struggle with: * Prolonged sitting (more than 45 minutes) without discomfort. * Lifting objects heavier than 2 kg. * Bending and twisting motions, especially when combined. * Maintaining good posture for extended periods at her desk. Is the employee fit to work? Based on my assessment today, Ms. Eleanor Vance is fit for duties taking account of the below recommendations What adjustments or work modifications are likely to help support this employee and for how long? Management may wish to consider the following to aid Ms. Eleanor Vance in making a successful and sustained return to duties: * Ergonomic workstation assessment and adjustments: Provision of a sit-stand desk and an ergonomic chair to facilitate postural changes throughout the day. To be implemented immediately and reviewed in 4 weeks. * Activity modification: Avoid prolonged static postures. Encourage regular micro-breaks (5 minutes every 30-45 minutes) for stretching and movement. Ongoing. * Lifting restrictions: Avoid lifting objects exceeding 2 kg for the next 8 weeks. Training on proper lifting techniques to be provided. * Phased return to full duties: Gradual increase in sitting tolerance and task complexity over a 4-week period, starting with 50% sitting time and gradually increasing by 10% each week. * Access to hydrotherapy: Facilitate access to a local hydrotherapy programme for 6 weeks to aid strengthening and mobility. * Managerial support: Regular check-ins from her line manager to ensure adherence to adjustments and address any emerging concerns. Is the medical condition long term and does it have substantial adverse effect (as defined by the Equality Act 2010)? In terms of compliance with the Equality Act, that is for a tribunal to decide as ultimately this decision is legal rather than medical. However, in order to provide guidance in this matter, it is my opinion that Ms. Eleanor Vance is likely to be covered within the scope of the Act. This is because she has a chronic back condition that has persisted for over 6 months, significantly impacts her daily activities and work performance, and is likely to continue for the foreseeable future, thus meeting the criteria for a substantial adverse effect. Therefore all reasonable efforts to accommodate her in the workplace would be expected of an employer. Does the employee have an underlying medical condition which is affecting their ability to work? Ms. Vance has chronic mechanical lower back pain, likely exacerbated by her mild L4/L5 disc protrusion. The UK incidence of lower back pain is high, affecting up to 80% of the population at some point. While acute episodes often resolve within weeks, chronic pain (lasting >3 months) can be challenging to manage, with recovery timescales varying greatly depending on individual factors and adherence to rehabilitation. Expected recovery with appropriate management and adjustments is anticipated over 3-6 months, with ongoing self-management strategies required. Is there likely to be a residual disability which will prevent the employee from carrying out normal duties? With appropriate workplace adjustments and consistent adherence to rehabilitation, the prognosis for Ms. Vance is good for a full return to normal duties. However, there is a risk of recurrence if ergonomic advice and activity modifications are not consistently followed. Approximately 20-30% of individuals with chronic lower back pain experience persistent symptoms despite interventions, but significant functional impairment can often be mitigated through ongoing management and employer support. Is the employee on treatment that is likely to impair their ability to work safely? Ms. Vance is currently taking paracetamol as needed, which is unlikely to impair her ability to work safely. She is not on any strong analgesics or sedating medications. Are there any circumstances, other than health issues, which might be having an impact on the employee at present, and whether there is anything the employer could do to help? Ms. Vance expressed some anxiety about the potential impact of her condition on her job security and her ability to perform well at work. She also mentioned childcare responsibilities make it difficult to attend appointments outside of working hours. The employer could offer reassurance regarding her job security and explore flexible working arrangements for physiotherapy appointments. Ms. Eleanor Vance has consented to the release of this information today to named management only and has been provided with a copy. If you require any further information please don't hesitate to contact me. Yours sincerely, Dr. Sarah Jenkins, Occupational Health Physiotherapist 1 November 2024