Occupational health practitioners are frequently asked for advice on fitness to return to work after surgery. Providing the best answer isn't always clear cut, and there is little evidence and often a lot of misunderstanding among patients and clinicians. There is a high level of variability between the time it takes different people to return to work after surgery and in addition to issues which are clearly medical there are often confounding issues such as non-scientific advice and inappropriate beliefs.
A study in the British Medical Journal asked a mixture of surgeons and GPs to recommend time off for adults in a variety of roles. There was a huge variation in answers, with a return to work after hernia surgery between 1-13 weeks (normal advice would be 1-2 weeks for manual work).
Another study looking at a group of 45 workers who underwent spinal surgery showed that 11 people returned to work on the next working day, many to adjusted duties and the average time to return to full duties was 2.5 weeks for light manual work and less than 6 weeks for heavy manual work. It is not uncommon for us to see patients who have been advised not to return to work for 6 months following such surgery.
Another study looking at return to work following carpal tunnel surgery showed that the time to return to work varied from 1 to 88 days and the recommendation of the surgeon had the strongest influence on the duration of absence.
Many surgeons give good advice regarding return to work and restrictions but in some cases this may not be evidence based and tends to often be overcautious, leading to a much longer period of absence than necessary. This can be a particular problem if long rest periods are recommended which can in turn lead to substantial deconditioning with weight gain and often difficulty for the patient regaining pre-surgery fitness.
There are 3 main fitness issues to consider after an operation. These are capability (the ability to get to work and physically cope), the second is safety (will they be harmed or cause harm to others by going to work and doing any particular activities), the third being motivation (how well they cope with pain, if they want to return or are seeking time away from work).
This requires a complex and individualised assessment which we at Infinity Occupational Health are experienced at making.
This requires the engagement of all parties and helping guide a patient back to work at an appropriate time, taking into account all of these factors. We use the best available evidence to guide us in this aim, ensuring patients do not return to work too early, and more commonly are enabled back to work sooner and with appropriate adjustments in place where needed.
If you require any further information, or would like to refer someone who has been absent from work following surgery, or is due to have surgery in the near future then please of course get in touch and we would be more than happy to help.