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Predictors of LBP and Return to Work

Through a light mobilization program, this team of researchers attempted to determine medical, psychological, and sociodemographic predictors that influence a worker's return after taking sick leave for low back pain. The researchers evaluated 260 workers who were on sick leave for 8 to 12 weeks.

Medically, they found that the mobilization treatment was effective in patients who did not have stiffness or restricted mobility at the beginning of the program. The researchers stressed to the patients the importance of not restricting use of the back or movement in the affected area.

Inactivity was found to delay return to normal activity and affect psychological disposition. Activity has been shown in both previous literature and in this light mobilization treatment program to promote well being and assist patients in overcoming the sick role. The researchers suggested the patients, "be encouraged to view themselves as healthy people who, unfortunately, have a bout of low back pain."

The researchers found those who returned to work felt the condition was under their personal control, as opposed to nonreturners who felt their health status was a matter of chance or others more powerful.

In addition the researchers found those who did not return to work to be influenced by sociodemographic factors as well. The study found that non-returners:

  • Were older.
  • Had more children.
  • Had more children living at home.
  • Had been in one job for more years.
  • Reported more physical workload.
  • And had reduced ability to perform ordinary work.

The researchers found numerous factors influencing a worker's propensity to return to work after a low back pain onset. Their findings led them to conclude:

"The results of the current study support the position that the prognosis for long-term pain is a multifactorial phenomenon. The good prognosis for this particular type of treatment depends on a combination of medical, sociodemographic, and psychological factors."

Haldorsen E, Indahl A, Ursin H. Patients with low back pain not returning to work. Spine 1998;(23)11:1202-1208.