Hi fellow physios

Am currently working in an Occ Health environment working for a company whose work involves prolonged standing (basically entire shift), repetitive squatting, and lifting of various weights up to 15kg.

My question is: what are the current recommendations regarding acute back pain and time off work?

The general accepted theory through research (from what I'm aware) is that:
* you should minimise time off work
* people with back pain should only have 1-2 days off work
* being back at work early reduces the total length of time off work
* being back at work can allow a quicker return to function

What currently happens is that patients are referred to see me with various MsK problems, and I determine their fitness to work, wether light duties are appropriate, and also if they should be at work.

I find that with people with quite simple back pain (no referred leg symptoms etc) that they above principles apply. But, do the same things apply for workers with acutely inflamed neural symptoms, high pain levels etc? Currently I judge each person as they present, and if they appear to be very inflamed, I can mentally justify signing them off work for a week or 2 at a time.

What about someone that is inflamed, but at 3 months off work? should they also be signed off, or returned to work asap?

Anyone have suggestions about better protocols to follow in these situations?

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