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Case 16: Lower back pain in ‘shunter’ driver

Company

Major multi-site biscuit manufacturer with an Occupational Health Department (OHD).

Injury

A ‘shunter’ driver from a factory complained of lower back pain, early in 2006.

Intervention

The driver was assessed by the company’s Occupational Health Department (OHD) and referred to the on-site physiotherapy service. He was seen by the physio for treatment and acupuncture, a total of 12 times between March and June 2006. During this time he was supported and regularly reviewed by the OHD, who liaised with his manager. 

The driver went off sick during the summer for a couple of weeks stating that he was taking Tramadol and was suffering the side effects of the medication. He saw the company doctor and a letter was sent to his GP requesting further information. The first report from the GP suggested that the GP believed the driver might have a prolapsed disc that needed rest from his ‘shunt’ driving as the ‘potholes’ in the yard were not helping his condition; she also advised that he would be better working in a HGV lorry, driving distances to deliveries. He had been referred for an MRI scan.

The company OH team did not agree with this, but the driver was insistent that his GP was right and he wanted to go on the road. OH met with his manager to see if any such work was available and he was subsequently put on driving duties, with the understanding that there would be no lifting or off-loading.

2-3 weeks later, the driver went off sick again. When seen by OHD it was discovered that he had been asked to help unload and, although he was fully aware that he was not to, felt he must.

This time, his absence was from August to mid-November 2006. The OHD had already enquired about ‘lighter duties’ for him to rehabilitate to work. The driver’s manager had suggested office type duties, which was agreed would be fine as long as there was training, a workstation assessment and ample opportunity to get up and walk about. The driver refused this option and chose to stay absent from work. In October 2006 the driver was again seen by the company doctor, this time the driver stated he had re-hurt his back, picking up boxes at home (the driver openly told the OH team that he had set up a home-based sales business).

The driver decided, when his company sick pay expired that he wanted to return to his driving duties, stating he had the results of his MRI scan and there was nothing wrong with his back!  OHD had already written to the hospital for the results and were not happy for him to return to the old duties before a hospital report had been received.  The report was received a week after OHD had started gradually integrating him into a controlled environment, in which he was to file receipts into small boxes.   He was not happy about this as he felt he should go straight back to driving.  OHD explained that it had to consider his health and safety and that a controlled environment would help him to get back to work in a safe manner.  Also, as he had felt it necessary to assist a customer previously, we did not want him to be put in this situation again.

Outcome

  This case is ongoing and the driver is due to go back to driving a shunt vehicle on a different site with a yard that has no potholes.  OHD have suggested that if he manages this type of work, where he can take regular breaks and get help if required, he should be OK to return to the road driving again fairly soon.

Lessons learned

The OH team were not completely aware of the full situation, being fairly new. In retrospect this case could have been managed better in the early days by restricting the driving earlier and placing the driver in a safer environment until he had received his MRI scan. This might have reduced his absence time and prevented a long-term sickness absence.  Additionally the driver had physiotherapy for too many sessions with the physio also believing that he had a more serious complaint. This demonstrates the need for a good OH team and good communication.

Updated 2012-11-29