Physical Therapy as Effective as Surgery for Meniscal Tear

Kathleen Louden

Mar 20, 2013

CHICAGO, Illinois — Patients with knee osteoarthritis and a meniscal tear who received physical therapy without surgery had good functional improvement 6 months later, and outcomes did not differ significantly from patients who underwent arthroscopic partial meniscectomy, a new clinical trial shows.

In the Meniscal Tear in Osteoarthritis Research (METEOR) trial, both groups of patients improved substantially in function and pain.

This finding, presented here at the American Academy of Orthopaedic Surgeons 2013 Annual Meeting and published online simultaneously in the New England Journal of Medicine, provides “considerable reassurance regarding an initial nonoperative strategy,” the investigators report.

Patients with a meniscal tear and osteoarthritis pose a treatment challenge because it is not clear which condition is causing their symptoms,” principal investigator Jeffrey Katz, MD, from Brigham and Women’s Hospital in Boston, Massachusetts, told Medscape Medical News.

“These data suggest that there are 2 reasonable pathways for patients with knee arthritis and meniscal tear,” Dr. Katz explained. “We hope physicians will use these data to help patients understand their choices.”

In an accompanying editorial, clinical epidemiologist Rachelle Buchbinder, PhD, from the Monash University School of Public Health and Preventive Medicine in Victoria, Australia, said that “these results should change practice. Currently, millions of people are being exposed to potential risks associated with a [surgical] treatment that may or may not offer specific benefit, and the costs are substantial.”

These results should change practice.

The METEOR trial enrolled 351 patients from 7 medical centers in the United States. Eligible patients were older than 45 years, had osteoarthritic cartilage change documented with magnetic resonance imaging, and had at least 1 symptom of meniscal tear, such as knee clicking or giving way, that lasted at least 1 month despite drug treatment, physical therapy, or limited activity.

In this intent-to-treat analysis, investigators randomly assigned 174 patients to arthroscopic partial meniscectomy plus postoperative physical therapy and 177 to physical therapy alone.

The physical therapy in both regimens was a standardized 3-stage program that allowed patients to advance to the next intensity level at their own pace, Dr. Katz explained. The program involved 1 or 2 sessions a week for about 6 weeks and home exercises. The average number of physical therapy visits was 7 in the surgery group and 8 in the nonsurgery group.

Investigators evaluated patients 6 and 12 months after randomization. The primary outcome was the between-group difference in change in physical function score from baseline to 6 months, assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). At baseline, demographic characteristics and WOMAC physical function scores were similar in the 2 groups.

At 6 months, improvement in the WOMAC function score was comparable in the 2 groups. The mean between-group difference of 2.4 points was not statistically significant after analysis of covariance. There was also no significant difference between groups in pain improvement or frequency of adverse events.

METEOR: Mean Improvement in Osteoarthritis Index at 6 Months

There was 1 death in each group, and 8 patients in the nonsurgery group and 13 in the surgery group withdrew in the first 6 months of the study.

Patients in the nonsurgery group were allowed to cross over to the surgical group at any time. Within 6 months, 30% of patients did so.

“They were not doing very well,” Dr. Katz said. His team is still analyzing the reasons these patients did not benefit from intensive physical therapy.

The 12-month results were similar to the 6-month results. In addition, by 12 months, outcomes for the crossover patients and for those in the original surgery group were similar.

Meeting delegate John Mays, MD, an orthopaedic surgeon practicing in Bossier City, Louisiana, who was asked by Medscape Medical News to comment on the findings, said most patients don’t choose physical therapy. “In the real world, most people want a quick fix” and choose surgery, he noted.

Dr. Mays said he would have liked to have seen a group of patients who underwent surgery but did not receive postoperative physical therapy. He explained that his patients with osteoarthritis and meniscal tear rarely get physical therapy after arthroscopic meniscectomy; they most often do home-based exercises.

He added that “most insurance plans have limits on the number of physical therapy sessions they allow.”

This study is funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Dr. Katz, Dr. Buchbinder, and Dr. Mays have disclosed no relevant financial relationships.

N Engl J Med. Published online March 19, 2013. Abstract, Editorial

American Academy of Orthopaedic Surgeons (AAOS) 2013 Annual Meeting: Abstract SE67. Presented March 19, 2013.

Gerry Gajadharsingh writes: I liked this one. When a patient is in a lot of pain and discomfort form an acute injury the tendency is to want to do as much as possible and sometimes this includes surgery. Interesting to know that actually waiting and following a conservative pathway can be as effective in certain conditions. ( By the way we are talking about knees)

Bad posture may give you headaches and even high blood pressure.

By Chloe Lambert

The Daily Mail 19 March 2013

Modern man is born to slouch. While our ancestors moved constantly as they hunted for food, we spend the vast majority of our time in static positions — either sitting or standing — when the temptation to slump and sag is just too great. ‘We fight against gravity the whole time,’ explains Robert McCoy, a lecturer on anatomy at the British School of Osteopathy. ‘It takes about ten minutes of sitting or standing before the muscles in the spine and abdomen that hold us up start to get tired, and we start to lean forward.’ Most of us know from experience that sitting hunched in front of a computer or driving wheel can lead to a stiff, painful back and shoulders. But poor posture can lead to other health problems . . .

IT CAN RAISE YOUR BLOOD PRESSURE The usual risk factors for high blood pressure are age, being overweight, smoking and chronic diseases such as type 2 diabetes. But scientists now think slouching may trigger it, too. This is because there is a link between neck muscles and the area of the brain that helps regulate blood pressure. In a study published in 2007, neuro-scientists at the University of Leeds found that when cells in the neck muscles sense the neck is moving, they send a signal to that area of the brain. The theory is that this helps ensure adequate blood supply when we change posture, for example from sitting to standing. But if the neck muscle cells become damaged or pressured through stooping and slumping, this could trigger problems with blood pressure, suggests Professor Jim Deuchars, the scientist who led the study.  ‘It’s possible that poor posture, which compresses the neck muscles, may be involved in high blood pressure, too, but more research is needed.’

. . AND LEAD TO DISTRESSING LEAKS Around half of all women suffer from bladder problems at some point, with many developing from stress incontinence, urine leaks when they laugh or cough. Poor posture may be partly to blame. When you stand correctly, your spine should form a slight S-shape, with a small curve near the neck and one at the lower spine.

Studies by physiotherapist Ruth Sapsford, at the University of Queensland, have shown that women with stress incontinence and who’ve suffered from a prolapse have less curves in their lower spine than women without these conditions. Sitting upright — with the spine adopting its natural curve at the bottom — engages more of the pelvic floor muscles, which support the bladder. If you’re sitting in a slumped, C-shaped posture, there’s more weight bearing down on your bladder and pelvic floor muscles, which will weaken them over time and make you more likely to leak,’ explains Sammy Margo, of the Chartered Society of Physiotherapy. ‘Apart from this, good posture can enhance your enjoyment of your sex life, as strong pelvic floor muscles are associated with more and better orgasms.’

…SLUMPING MAKES YOU SAD AND SHY A study of 110 students by San Francisco State University last year found those who walked with a slouched body posture reported feeling more depressed and having lower energy levels than those who were more upright.

Study leader Erik Peper, a professor of health education at the university, says sitting or standing up straight with shoulders back does not just give other people a good impression, but also sends a message to the brain that makes us feel better about ourselves.  Meanwhile, in a 2007 study at Colorado College, students with the best sitting posture felt more confident and scored significantly higher on tests than those who sat slumped. Interestingly, though, the trend was only true for male students. Women felt more confident if they’d slouched, possibly because men tend to determine how they feel according to internal cues, while women think more about how they look to others for them an upright posture made them feel pressured and self-conscious.

….IT MAY TRIGGER HEARTBURN. According to some experts, one of the consequences can be heartburn where stomach acid travels into the oesophagus, causing chest pain. ‘The pelvis is like a bowl, and when we stand up straight we hold it flat,’ says Robert McCoy. ‘But as you shift forward, the bowl tips forward and the contents, such as the stomach and digestive organs, shift, too.’

….AND ASTHMATICS MIGHT STRUGGLE ‘You’ll notice that people don’t sigh when they sit slumped they have to sit up to take a deep breath,’ observes Professor Stephen Spiro of the British Lung Foundation. ‘That’s because the lungs work best when we’re vertical. If you’re slumped forward you don’t fully breathe and ventilate the lungs, because they’re compressed and the diaphragm is coming up into the chest — so you won’t breathe as easily and efficiently. If you’re an asthmatic you probably don’t have bad posture because people are quite clever at correcting themselves,’ says Professor Spiro.

….IT CAN TRIGGER HEADACHES If you find you suffer headaches while at work, it might be the way you sit, rather than the stress of your workload that’s the source of the problem.‘When sitting at a desk, as the muscles in the back and stomach start to tire and the spine starts to slump, we tend to stick the neck and chin forward to keep the eyes in a good position, so we can still see the screen,’ says osteopath Robert McCoy.‘Tension in the muscles at the base of the skull, caused by the spine rounding and the neck sticking forward, can pinch the trigeminal nerve in that area, leading to something called cervicogenic headache. It tends to be characterised by pain that starts at the back of the head and travels up and over and ends just above the forehead.’

…..AND LEAVES YOU BLOATED One in seven Britons is thought to suffer from irritable bowel syndrome, and even more find they feel bloated after eating. Dr Michael Mendall, a gastroenterologist at Croydon University Hospital, says stooping can make feelings of bloatedness worse because it squashes the abdomen — so after a big meal, sit up straight to avoid discomfort. Interestingly, he says bloating is a common side-effect of osteoporosis, the brittle-bone disease affecting three million people in the UK, which can alter posture. ‘As your spine crumbles you slump and lose volume in the abdominal cavity, so people find even though they are eating normally they feel full and bloated.

Gerry Gajadharsingh writes: As an Osteopath I know all of this but I guess it is news to many patients and its good to see it highlighted in the mainstream press. I remember having conversations with BUPA as to why a GIT specialist had been referring me patients, they simply couldn’t get it, c’est la vie.

Handing out steroid cream can leave children in pain: How GPs are adding to the agony of eczema

By Maria Lally  

The Daily Mail 19 March 2013

Looking down at my 20-month-old daughter Sophia’s feet, my heart nearly broke.The skin was angry, cracked and bloody. She had similar patches on her legs, tummy, back and arms and was frantically scratching any area she could reach until the skin split.

The next day I took her to our GP — again. He took a brief look at her feet (by now so red and scabbed they looked burnt), said he’d seen worse, then handed me yet another prescription for steroid cream, even though I told him we had several half-used tubs at home.

Then, just after her second birthday, she suffered a vomiting bug and for two days had just water and dry toast. Her skin became beautifully clear.

When she was better she had a beaker of milk and her eczema came back immediately. I told my GP, who scoffed at the idea of a food allergy — even though my husband Dan is allergic to milk and eggs and had eczema as a child.At this point Dan and I had had enough — we decided to get private treatment and, at a cost of £760 and with a change of diet, Sophia’s skin is finally clear.

But all that expense — and months of misery — could have been avoided if the GPs we saw had done the right thing.‘GPs often don’t know how to handle eczema,’ says Dr Susan Mayou, a dermatologist from the paediatric department at the Chelsea and Westminster Hospital. ‘It’s not life-threatening, there’s no one-cure-fits-all and they often don’t have enough training.’

While there is no single cause of eczema, experts agree that it is largely inherited. If a parent has or had it, their child is 60 per cent more likely to get it. This rises to 80 per cent if both parents have it. As many as two-thirds of children with eczema (but especially those who develop it before the age of one) will also have a food allergy, according to the NHS. Under guidelines from the National Institute for Health and Clinical Excellence (NICE), GPs are meant to ask parents to ‘consider a diagnosis of food allergy’ if children under 12 have eczema that isn’t responding to treatment. ‘If food allergy is suspected, GPs should refer the child to a dietitian or dermatologist.GPs are also meant to advise parents on how to prevent and spot infected eczema.It’s clear that too many GPs don’t know about these guidelines, or stick to them if they do.

‘I worked on putting the NICE guidelines together and it’s frustrating that some GPs just don’t follow them,’ says Dr Adam Fox, the private dermatologist whom we ended up seeing. Parents feel fobbed off and see specialists like me — or, worse, they start to self-treat their children by cutting out foods or using steroid creams without proper advice.’

Margaret Cox from the National Eczema Society adds: ‘Your GP will be lucky if they’ve had six days’ training in dermatology.Many see eczema as a minor complaint, know little about it and have no idea of the challenges faced by families living with it.’

Bad eczema is the condition Dr Fox says he would least like his own child to have. ‘It’s horrendous. I meet teary-eyed parents who are exhausted and struggling,’ he says. ‘Their child has been up all night scratching for weeks, even years. The family doesn’t sleep properly and are miserable, yet their GP treats them the same as somebody with a small patch of dry skin. Many dermatologists would love to get their hands on some GPs and teach them about eczema.’

On our two family holidays, the sand and seawater made her cry out in pain and sun cream caused flare-ups so she barely spent time outside. Or she sat in her pushchair watching other children build sandcastles or play in the waves. Bath time was torturous. Eczema needs to be clean (split skin allows bacteria to enter and becomes infected) and moisturised. But water and cream sting raw skin, causing screams during flare-ups. Anyone who thinks toddlers are a handful should try looking after a sleep-deprived one who has a burning sensation all over their body.

Research published in the journal Psychology Today, found that 83 per cent of children with eczema have trouble sleeping. They are also more likely to ‘suffer from behavioural disturbances’ caused by broken sleep, according to the Journal of Clinical Sleep Medicine.

Desperate, we paid £580 to see Dr Fox. He asked about my and Dan’s health and ran allergy tests.We quickly discovered that Sophia, like her father, was allergic to milk and eggs.

Dr Fox said diet would help but also prescribed a week’s course of Elocon, a strong steroid cream, to control her eczema while the diet kicked in. He explained that eczema — which means to bubble and boil over in Greek — is like a bush fire: when it takes hold, it rages.You need to put out the fire with strong steroids, and then keep it out with suitable treatment.

A dietitian (a further £180) created an egg- and milk-free diet for Sophia and we started using Aveeno twice a day — a fantastic cream that contains finely milled oats (an anti-irritant) and leaves a protective barrier on the skin.Within three days the red patches had softened and after a week Sophia’s skin was clear. She hasn’t had eczema since. She sleeps better, behaves better and our family life is transformed.

‘Sixty to 70 per cent of children who get eczema in the first year of life have a food allergy,’ Dr Fox told me. ‘And children with eczema that doesn’t respond to standard treatment with steroid creams tend to have food allergies.’ In fact, the same applies for adults. GPs see an enormous number of children with eczema as it affects 20 per cent at some point. Most have it mildly and steroid cream works fine. But some don’t respond and alarm bells should ring. GPs should refer them to a specialist.’

Dr Mayou adds: ‘If your child’s eczema isn’t improving, ask your GP why. Push for a referral to a dermatologist and flag up any family history. Give your child regular baths that are warm, never hot, and apply Aveeno several times a day.’

Gerry Gajadharsingh writes: Finally a Dermatologist is saying what it really is, don’t just treat the symptoms of skin conditions look at what is the underlying cause, for children and in my opinion many adults food may be the culprit, the question is does the person what to give up what they are reacting badly to?

Inactivity ‘as bad as smoking’

The Independant Wednesday 18^th July 2012 by Jeremy Laurance

Sitting about doing nothing is about as damaging to health as smoking, doctors say. Physical inactivity may be responsible for as many as one in 10 deaths worldwide – mainly from heart disease, diabetes and breast and bowel cancer. If exercise – such as brisk walking for 30 minutes, five days a week- could be bottled, it would be a miracle cure. A series of research papers published in The Lancet today show that millions of lives could be saved if people were stimulated by the spirit of the Olympic Games to get active. Around a third of adults globally and four out of five adolescents, are doing so little they put themselves at significantly greater risk of disease. The UK has one of the most inactive populations with 63% of adults failing to do enough. Improved street lighting, cycle lanes and more green space can boost activity levels by 50 %. Simple measures such as signs encouraging people to use the stairs rather than the lift can also have an impact. One of the most effective interventions, known as ciclovia which originated in Columbia and translates as “cycle path”, involves closing city streets to vehicles on Sunday mornings and holidays and opening them to walkers and runners.

Gerry Gajadharsingh writes:

With Olympics fever with us, what a great time to engage in sport, not only will you have a great time you’ll be doing something great for your body and mind!

Calls to Mental Health Charity reveal human cost of recession.

By Nina Lakhani The Independant 21.05.12

High unemployment rates and rising living costs have led to a surge in calls to leading mental health charity which is struggling to cope with demand.

Mind’s info line dealt with more than 40,000 calls in the past 12 months, but an unprecedented high volume meant two in every five calls went unanswered. The number of people seeking advice about personal finances doubled since the start of the financial slump in mid 2008. The casual link between economic depression and mental health problems is well established, though Britain has thus far been spared from the rise in suicide seen in Greece and Ireland, where the financial collapse has been felt most acutely. The suicide of Dimitris Christoulas in Athens last month led to much soul searching due to his note said he could no longer live with dignity on a pension cut to the bone.

Mind’s info line, which provides advice ranging from how to access treatment to managing debts, dealt with 18% more calls between October 2011 and April 2012 compared to the same period a year earlier. Calls to its legal line increased by 28%. There are signs the impact of the ongoing crisis is spreading to previously unaffected families, with more and more employed people reliant on food handouts. Mind’s figures come as the country prepares for a double dip recession and at least another year of pay freeze, and precarious employment. Yet many mental health groups face an uncertain future due to cuts. Paul Farmer executive of Mind said: “Dealing with this is a job for everyone, government, employers and charities, as getting Britain out of recession is as much about the mental health of the work force as it is about economics.” Stress, depression and anxiety already cost the economy £30bn every year. This could be cut by a third if employers improved the way they dealt with workplace stress and mental ill health. Francoise, 49, a customer services co-ordinator at a blue chip company became depressed about 18 months ago due to mounting work pressures. Poor concentration and anxiety made coping with work difficult until she reached breaking point last June. But with support from Mind, A Therapist, medication and a psychiatric nurse, she will soon return to work. Health Minister Simon Burns said: “We are boosting funding for talking therapies by £400m over four years from April 2011. This will ensure that evidence- based therapies are available to all who need them.”

Gerry Gajadharsingh writes

NICE has approved mindfullness therapy as a recongnised treatment for anxiety and drepession, what is mindfullness? Breathing and Meditation.

I’m not taking a daily pill if I’m not sick.

Terrence Blacker Health The Independent Friday 18^th May

 The doctors have found something new to nag us about. Having thundered against smokers (inside, outside, active, passive), sermonised weightily around the perils of drink, and warned us that, unless we stop getting fat, these islands will soon sink under our weight, they have now turned their attention to the over 50’s.

A study published in the latest edition of The Lancet suggests that everyone in that age category should now be taking some drugs called statins everyday. By reducing cholesterol in the blood, the argument goes; the pills cut by 15% the chance of someone in the low- risk category suffering a fatal heart attack or stroke. Fewer people would die, and the cost to the NHS of screening and healthcare would be reduced. Here is the new double- whammy of generalised medical advice: not only is this good for you, it is great for the country and the economy.

The role of doctors in our world has changed in the past 5 years. Not so long ago, their work was with individual patients: now they are on hand everyday to provide the latest bossy prescription as to how we should all live our lives, like secular priests scolding us from the pulpit of science. It is not difficult to see how this happened. We live in an anxious, self analysing culture. Government, fretting about the rising healthcare cost of an ageing population, has become increasingly interested in the idea of prevention reducing the need for cure. Together individuals and politicians have turned to the medical profession for advice. Doctors, few of whom are over burdened with problems of self esteem at the best of times, have allowed the attention to turn their heads. It should go without saying that the idea of millions of healthy people taking a daily pill is distinctly creepy. Common sense, even if it is not to be found in the pages of The Lancet, suggests that messing around with the metabolism of a healthy human is unnecessarily risky.

The new report claims, unconvincingly, that taking a cholesterol reducing pill would offer , “a benefit that greatly exceeds any known hazards of statin therapy”. That little qualifier “Known” gives one pause, as does the list of potential side effects: muscle wastage, liver damage, stomach upsets, sleeplessness, memory loss, “bleeding strokes”, and diabetes. The human spirit would also be infected. When a larger part of the population is told that it needs to be medicated by the state in order to stay alive and do its bit for the economy, it is not just cholesterol that is being reduced.

Doctors do wonderful work in the surgeries, But it is time for them to stop self importantly prescribing to society as a whole, particularly when their advice involves shovelling an unnecessary drug into their bodies of the healthy. They are giving us a headache.

 Gerry Gajadharsingh writes

Hmmm, difficult one. The evidence that statins can help reduce cardio0vascular risk in men of a certain age is strong, perhaps more to do with lowering inflammation than just reducing cholesterol. However there are ways of reducing cardiovascular risk by lifestyle factors including the right nutritional advice. There is increasing evidence that reducing cholesterol is not just about reducing saturated fats but also reducing high glycaemic load carbohrdrates, this message has not yet filtered out to the person in the street! However I agree that managing risk is a personal choice, we all sometimes choose to do things that we know may not be good for us but it is our choice.

A doctor’s strike would betray their patients

by Sarah Wollaston Conservative MP for Totnes and a former GP

The Daily Telegraph 16-05-2012

The BMA is being unrealistic in opposing reasonable increases in pension contributions.

This week the British Medical Association is trying to persuade doctors to vote in favour of a strike action- the first such action since 1975.In doing so, the BMA proves yet again how out of touch it has become with the interests of patients and doctors alike.  When I joined the BMA in 1986, I was unaware that it was a union. I had assumed that it was a professional organisation supporting standards and education. And like most doctors, I joined mainly for a free copy of the weekly British Medical Journal, which at that time was the only way to find out what jobs were available. Now in a “Pension Ballot Special” a BMA newsletter tells members that the association has no choice but to vote on industrial action for a “fairer” approach. It splashes on the 14.5% that, crucially, only the highest paid doctors will have to contribute towards their pensions. It claims, misleadingly, that no patients would be harmed by industrial action.

The BMA tries to persuade doctors that they could open for their usual hours during industrial action but not carry out any pre- booked or routine appointments, or issue any repeat prescriptions. Likewise, hospital colleagues are invited to turn up and make decisions about what is or is not an emergency. The results would not only be farcical but dangerous: doctors would find themselves facing an exasperated and irritated public. If that sounds unreasonable the BMA industrial relations officer will be on hand to give guidance. He or she can expect to be very busy. The public is unlikely to have much sympathy.

Thirty years ago things were very different, doctors were relatively underpaid but their vocation and professionalism commanded public respect. Labour changed all this in the 1990’s. GPs ditched out of hours work and Saturday surgeries and the European Working Time directive was also waived by Labour, which undermined continuity of care and worsened working conditions for junior doctors.  Assuming that all consultants were on the golf course or seeing private patients, the government insisted that they should be paid only for the time that they spent on NHS work. It should have come to no surprise that it ended up paying even more because of unpaid time that consultants were previously giving to the service for free. A decade later, doctors are well paid and few GPs work Saturdays or nights. The public are simply not going to feel sorry for striking doctors who earn more than £100,000 per year, sometimes for a four day week. To put the issue into perspective, doctors earning more than £120,000 pay 8.4% of that into their pension pot. This would eventually rise to 14.4 % after tax relief. To get an equivalent pension in the private sector would require about a 3^rd of the same salaries- and doctors are living about 10 years longer than they did in the 1970’s. The rest of the country has woken up to the reality of pension costs- and we are soon to witness what happens to a country like Greece, which has failed to do so. No government wants to pick a fight over public sectors pensions, but to ignore demographic and financial realities would dump the burden on the next generation. I hope that doctors will follow at least one aspect of the BMAs advice, “whatever your views, it’s vital you vote.”

 As an MP, I now pay 13.75% towards my pension, and work evenings and many Saturdays. Of course one of the main differences between an MP and a GP is the way people feel about you. I hadn’t realised how much people respected doctors until I entered parliament. That support matters and a vote for strike action over pensions is a sure way to lose it. Perhaps every doctor should ask a friend in the private sector how much pension they will receive, and how much they must contribute. They might be in for a shock. The BMA have made the wrong call: this is unnecessary strike would not be victimless. I sincerely hope that doctors will vote to put their patients first.

Gerry Gajadharsingh writes

Its great to see a former GP speaking out. Anybody running a business wil know how hard it is out there in the real world. Most people I know in the private sector have minimal pension provision, we simply cannot afford it. For those  luckily enough to have state pensions, should realise what a good deal they are getting, are we all in this together perhaps the BMA thinks not?

Sickness rates worse for public sector staff.

Although UK absenteeism is declining reports Louisa Peacock. The Daily Telegraph 16-05-2012

Public sector workers are 63% more likely to pull a “sickie” than their private sector counter parts official figures show, as overall absence rates fall to a record low.

The date from the Office for National Statistics (ONS), shows public sector absence hit 2.6% last year, compared with 1.6% in the private sector. This means state workers are 63% more likely to take time off than their industry counterparts. The ONS said that private sector workers were less likely to get paid for their sick day which may have been what could have driven the “sickness gap”. However some occupations- such as police and nursing- had likelihoods of absence which could also explain the gap, while the public sector employed more women, who generally have higher sickness rates than men. Overall the UK Sickness absence rate fell to 1.8% last year, down from 1.9% in 2010 and the lowest since comparable records began in 1993 when it was 2.8% .Women have consistently higher absence rates than men, but both sexes have seen a fall over the past 19 years. Older people generally took more sick days than other ages echoing a long term trend. The most common reasons for sickness last year included back problems and minor illnesses such as coughs, colds and flu.” However there has been a 10% increase over the past year of people taking time off due to stress, depression and anxiety. London workers had the lowest sickness rates at 1.3% last year, potentially because of the volume of young and private sector staff. The North East and Wales suffered the worst rates at 2.5% because they gad more public sector staff. Business groups repeated calls for the government to adopt a new approach to help firms manage sickness absence, which is costing the UK economy £15bn a year.

Gerry Gajadharsingh writes

I was first invited to a parlimentary working group on work sickness about 20 years ago at the time back pain was the most significant cause of taking time away from work. Fast forward 20 years and stress is now up there. Actually stress/anxiety has always been there its just that clinicians and patients are now more accepting that anxiety can play a part in many work related illnesses.