Distraction of work beats doctors for back pain relief

Backache is common, hurts like hell and no one has the first idea how to cure it. Neither do they know what brings it on. It can be too much jogging. Or lifting something. Or sitting hunched over a computer all day. Or, as happened to me, it can result from standing on one foot trying to insert the other into a sock.

Given that the whole of Europe jogs, lifts things, sits slumped over desks and puts on socks, you might have expected the incidence of bad backs in Europe to be evenly spread. Possibly, at the margin, backs ought to be slightly healthier in richer countries where there are stricter rules on how to lift things, and where more gets spent on ergonomic office furniture.

Yet last week I came on some numbers that suggest otherwise. According to research by the Work Foundation, Germany leads Europe by a mile when it comes to fussing over its aches and pains.

Every year Germans throw 217 million sickies as a result of musculoskeletal disorders (which mainly means backache). In the UK the figure is 35 million days – which is a lot in absolute terms, even if it is nothing by comparison – while in Greece it is only a million. Even if you adjust for the size of the workforce, the gap is still enormous – the average German worker takes a whole week off work every year, compared with a day in the UK, and barely an hour in Greece.

Slightest twinge
It strikes me as vaguely comic that the country that is strong enough to carry the whole of southern Europe on its back stays home at the slightest twinge while the country with the feeblest economy in the EU shows a lot of backbone when it comes to backache.

Partly it is a difference in the benefit systems: in Germany you go on getting handsomely paid when your back plays up. But benefits don’t account for the full extent of the difference. Neither does job satisfaction. Normally how much people like or loathe their work determines how often they phone in sick. But that would suggest that people would be absent less in Germany, where job satisfaction is fairly high, at least compared with Greece.

So what is going on with the German back? While the French get excited about their livers, and the Brits obsess over their bowels, in Germany it is the spine that is grotesquely overpathologised.

I know this from (very) painful experience. Twenty odd years ago I moved to Bonn and had been in the country less than a fortnight when I put my foot in my sock and my back went. I can’t blame Germany for that. But I do blame it for what happened next. Over the next few weeks the GP sent me off for one unsuccessful treatment after another: I had electric shocks, drugs, massage, physiotherapy and a punitive exercise regime. I had needles stuck into me. I had something injected straight into my spine and I was even made to lie on a hot, wet, brown mat made of volcanic material.

Even if I hadn’t been on maternity leave at the time there is no way I could have gone to work because the treatment was a full-time job. But far from making me better, all the prodding and poking made me steadily worse until finally I was taken to hospital, where I was kept in bed for two weeks. And even when I could get out of bed, I wasn’t allowed home because I had to have a week of water therapy.

Indecently healthy
How serious is all this? Twenty years ago there was a cover story in Der Spiegel arguing that the "back epidemic" was costing employers DM12 billion a year and was killing the economy. Twenty years later Germany is still alive and its economy is almost indecently healthy.

The back-of-a-fag-packet calculations on what absenteeism “costs” employers are wildly overstated: the slack created by the absent person is usually taken up by everyone else. And in Germany’s case there is the offsetting effect of the job-creation scheme for back therapists and vendors of volcanic mud.

The only group hurt by this wasteful system are the patients. As soon as I returned to the UK, back still playing up, I started working again. This was the most therapeutic thing I could have done. Clearly if you can’t move, you can’t go to the office, but if you can, the chairs there are better than badly upholstered sofas at home. At work, the pain in my back eventually subsided on its own. In the meantime ibuprofen in the day and wine in the evening worked wonders.

The best thing about work is that it is distracting. The spine is a suggestible organism: merely writing this column has set mine jingling so unpleasantly that I must stop now.