Occupational injury, chronic low back pain and return to work

Abstract

Motivation for work, the level of physical disability, the duration of unemployment before rehabilitation, completion of an employment rehabilitation course, and unemployment in the general population are known to be the major determinants of an early return to stable employment among the economically active and chronically disabled adults. The type of main impairment causing chronic disability does not seem to be a major factor in predicting a successful outcome of rehabilitation. In a study of 311 men and 26 women with chronic low back pain (CLBP) who were discharged from three rehabilitation centres in the Greater London area, 88 (26.1%) of the patients attributed their CLBP to occupational injuries, 36 (10.7%) had sustained non-occupational injuries, and the remaining patients did not give a history of injury. The outcome was assessed in terms of an early return to stable employment during a one year period after discharge from the centres. A history of occupational injury appeared to have an adverse effect on the outcome, but non-occupational injuries appeared to have the opposite effect. This effect was probably a function of the level of physical disability and motivation. Other factors, such as age, social class, income, welfare benefits and compensation, did not make an independent contribution to the prediction of the outcome. Possible explanations for the apparent associations are discussed.