Beyond this time, inactivity becomes a detriment to most patients. Studies have demonstrated that moderate, unloaded activity has a distinct positive effect on healing. Some employees with back injuries are lost to the workplace and to society in general because of the lack of an organized system of treatment, rehabilitation and communication. Some individuals malinger because they derive income from the disability, receive sympathy and attention from friends and relatives, and also escape responsibility or get revenge against the employer. There are positive features of an early return to work program as opposed to inactivity.
Work provides self-esteem, social contact and acceptance in the community.
Physiologically, it prevents loss of tissue flexibility and decreased muscular competence and psychologically, the injury is perceived as just temporary. One of the most significant factors in decreasing incapacitating pain and dependence on physicians and drugs is an early return to work. Working individuals view themselves as more active, more mobile, and better able to cope than non-working individuals. The impact of management attitudes cannot be underestimated in safety and rehabilitation programs. The credibility and impact of such programs is determined largely by the importance given to them by top management.