Following up
Getting back to it
"Back pain: don't take it lying down." Since 2005, the Alberta Workers' Compensation Board and its partners have promoted this message as a public-service announcement to Albertans.
Story by Tara Narwani/Photo by Dustin Delfs
The old counsel was "Stay in bed and rest if you have back pain". This is no longer considered good advice. In fact, the evidence shows the opposite. "Stay as active as you can and you'll get better quicker," says Dr. Douglas Gross, a professor of physical therapy at the University of Alberta. With support from the Health Research Fund, Dr. Gross has been evaluating the Alberta Workers' Compensation Board (WCB) campaign, to measure its success as a public-health initiative.
The strategy was inspired by an Australian campaign in the late 1990s. Back pain was on the rise in Australia; it was resulting in increased absence from work, higher rates of disability, and higher healthcare costs. The traditional medical approach of advising bedrest until patients felt better wasn't working. To combat the problem, the workers' compensation authority in the state of Victoria ran a series of 36 television commercials with the same slogan: "Back pain: don't take it lying down."
"That campaign had a really dramatic impact on the beliefs of the population, as well as the beliefs and practices of the physicians in the state. And, most importantly, they saw a reduction in disability and healthcare costs," explains Dr. Gross. The hope was that similar results could be achieved here.
Because of the high cost of television advertising, the campaign in Alberta has been conducted by means of province-wide bus ads, workplace posters, and radio commercials. Olympic speed skater Catriona Le May Doan was the spokesperson in 2006.
To evaluate the impact of these efforts, Dr. Gross conducted annual telephone surveys from 2005 until early 2008. Over the three-year period, the data showed a 7% increase in the number of people who agreed with the statement "If you have back pain, you should stay active." Although 7% sounds like a modest gain, it represents a large number of Albertans whose beliefs have changed, according to Dr. Gross.
In contrast to the effects of the much larger Australian campaign, changes in beliefs failed to result in corresponding changes in behaviour where Albertans were concerned. People with back pain visited their healthcare providers the same number of times. And the number of days people took off work due to back pain remained the same.
Since it may take somewhat more than three years to see such behavioural changes, the WCB is continuing the campaign for at least one more year. Dr. Gross hopes the message will be expanded to include specific advice on how to stay active with back pain. "I think there's potential to really change the way back pain is handled here in Alberta."