Renovations took place in the office in which she was employed many years prior, and Ms P willingly contributed to the renovation work. While pulling up carpets and moving heavy furniture she developed back problems. She was treated by a doctor for this issue soon after. 

Due to ongoing back pain Ms P often had trouble moving and frequently needed to lie on the floor for some relief. She was at times absent from work for many weeks. In the years after the incident Ms P was referred to an orthopaedic surgeon who arranged injections (likely facet joint), as well as physiotherapy, medication and a suggested exercise regime. Despite this, her back continued to be troublesome.

She found her back to be less painful when moving around. Due to the constant sitting required in her office role, she resigned in 2013. She began working part-time in a retail environment. She noted this role was better for her back problem, with the regular movement needed.  

Her back pain flared, but as she had not been treated for two years, Ms P was required to lodge another claim.

An MRI scan showed multilevel intervertebral disease, most prominent at the L4-5 level. There is no disc protrusion or sciatica. 

In the new claim form, the cause of the back pain was reported as the injury during renovation work.  Ms P is asked if she had experienced back pain prior to the renovation work injury and advises she has not. 

Approach

Assessing whether the back problem is because of the renovation injury is important to ‘get right’. 

The back condition is a long term so the assessment of work contribution may determine whether long term treatment and permanent impairment is paid.  And whether any future time off work is covered. It is important to assess the condition thoroughly, both for Ms P and for the compensation system’s integrity.  

Studies of large groups of people tell us that back pain is common. 20% or more of the population has a long term back complaint, where they experience some level of back discomfort or soreness on most days.  More than 30% of people experience intermittent episodes of back pain. Only about 30% of the working age population have never experienced back pain. It is rare for people to move from experiencing no pain to experiencing constant back pain. Studies of large groups of people tells us long term back pain typically starts in a person’s teens or twenties, and uncommonly after a specific incident / injury. 

A patient’s memory of past health issues can be unreliable. 70% of the population report having experienced back pain at some point in the past, however following a specific work injury many report no prior problems. It is normal for people to forget their past medical problems. This is regardless of the condition is back pain, hay fever, abdominal pain, etc.  When there has been a specific injury which is documented, requires certificates, and has a significant impact on the person’s day to day life, the individual is more likely to recall the event and what happens with their condition after that episode.  

Studies also tell us the greater the number of ways we ask about prior problems, the more we are likely to learn about prior problems. Questions could include ‘have you had any prior back pain?’, ‘have you ever been to a physio or chiropractor (prior to the injury)?’, ‘have you had any x-rays or scans of the back in the past?’

Patients presenting with long term back pain need to be questioned carefully.  Where possible, contemporaneous medical records should be accessed and reviewed.  These records are the most accurate method of assessing whether there have been prior significant back pain.