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Beliefs are central to our responses to a health problem, and influence what we do about it. Myths and legends abound, and are major obstacles to stay-at-work, and return-to-work. Many obstacles are related to these common myths. They are exceedingly pervasive, having negative effects on the behaviour of all involved, and the interactions between them.


Myths about common health problems need to be challenged and dispelled


Symptoms (e.g. pain, fatigue, worry, stress) means serious illness, damage, or injury


This is not always the case: symptoms such can occur without disease or injury.

Even when specific tissues are affected, activity and work are not precluded.

Temporary discomfort or distress is often part of recovery.

Why it Matters

Believing symptoms means harm results in activity-avoidance behaviour, which are obstacles for stay-at-work and return-to-work initiatives.

Worrying about ‘damage’ and ‘injury’ is an obstacle to active interventions that see work as a therapeutic intervention.

Work/activity is the cause:
something is damaged

Symptoms are common across the whole population, regardless of type of work.

Work or activity can trigger symptoms, but most work is unlikely to cause substantial damage.

Erroneously blaming work leads to an undue concentration on simplistic explanations for the causes of symptoms, which gets in the way of effective interventions tailored to specific circumstances.

Work/activity will make matters worse

The actual condition is usually not made worse by continuing work (assuming control of significant risks).


Work may become difficult or uncomfortable, but that doesn’t mean it is doing harm.

Work is generally good for health and wellbeing, so the belief that work is inherently dangerous is unhelpful, and poses a major obstacle to helping people get back to work or stay at work.

Medical treatment is necessary

​Most people, for most episodes of a common health problem, do not seek healthcare.

Reliance on healthcare alone is not enough to help with return to work

Over-cautious behaviours can be powerful obstacles to recovery and return to work.

Reliance on medical treatment alone negates the possibility of involving the workplace in helping people back to work.

Injuries and health problems
must be rested

Quite the contrary – activity leads to faster and more sustained recovery and return to work.

Temporary reduction of activity may be required, but long-term rest is detrimental.

Using rest as a treatment is a major obstacle to modern management strategies that encourage and support return to activity/work.

Advising patients to take unnecessary rest can give the disadvantageous impression that the problem is serious.

​Sick leave is needed as part of the treatment

Often sick leave is not needed – staying at work is desirable, perhaps with some temporary modifications.

The use of ‘fit notes’ is preferable to sick notes: emphasise what the person can do, not can’t!

Helping people stay at work can contribute to their recovery.

Injudicious use of medical certificates reinforces fears and uncertainty, and encourages reliance on rest, whilst fostering fears of activity.

Contacting an absent worker is intrusive

Continued contact with the workplace is crucial to the return to work process.

If the approach is positive and un-pressured, workers are appreciative.

Failure to make early contact with people who are off work leaves them isolated and unvalued, thus fostering distress or depression.

Lack of contact means these is no chance to make a return to work plan, and no chance to discuss transitional working arrangements.

No return to work till 100% fit and symptom free

This is clearly unrealistic and unhelpful - many workers can and do return with ongoing symptoms, and they to come to no harm.

Employers’ policies that restrict work-return to those who are symptom free or fully fit for their usual work are counterproductive, and are a major obstacle.

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