Has there been a change in the rates of UK sickness certification for back pain over time? An examination of historical data from 2000 to 2010

OBJECTIVES: This paper aims to investigate historical patterns of sickness certification for back pain from 2000 to 2010. DESIGN: Electronic medical records from 14 practices that are part of the National Institute for Health Research (NIHR) Clinical Research Network: West Midlands were reviewed. All records for back pain consultations from 2000 to 2010 were downloaded and matched, by date, to corresponding sickness certification records. SETTING: Primary Care. RESULTS: A total of 93 896 back pain consultations were recorded over the 11-year period, resulting in 30 913 sickness certificates. There was a statistically significant decrease in the rate of certification over the period, falling from 376.8 (95% CI 362.1 to 392) per 1000 back pain consultations in 2000 to 246.5 (95% CI 236.5 to 332.9) per 1000 back pain consultations in 2010. There was also a statistically significant difference in certification between males and females, with males issued more certificates than females. There was a statistically significant difference in certification by age, with those aged 60 years and over being less likely to be issued a certificate compared to all other age groups. CONCLUSIONS: Rates of sickness certification for back pain demonstrated a downward trend between 2000 and 2010. While the reasons for this are not transparent, it may be related to changing beliefs around working with back pain.