Absence from work and return to work in people with back pain: a systematic review and meta-analysis

Abstract

BackgroundA considerable proportion of work absence is attributed to back pain, however prospective studies in working populations with back pain are variable in setting and design, and a quantitative summary of current evidence is lacking.ObjectiveTo investigate the extent to which differences in setting, country, sampling procedures and methods for data collection are responsible for variation in estimates of work absence and return to work.MethodsSystematic searches of seven bibliographic databases. Inclusion criteria were: adults in paid employment, with back pain, work absence or return to work during follow-up had been reported. Random effects meta-analysis and meta-regression analysis was carried out to provide summary estimates of work absence and return to work rates.Results45 studies were identified for inclusion in the review; 34 were included in the meta-analysis. The pooled estimate for the occurrence of work absence in workers with back pain was 15.5% (95% CI 9.8% to 23.6%, n=17 studies, I2 98.1%) in studies with follow-up periods of ≤6 months. The pooled estimate for the proportion of people with back pain returning to work was 68.2% (95% CI 54.8% to 79.1%, n=13, I2 99.2%), 85.6% (95% CI 78.2% to 90.7%, n=13, I2 98.7%) and 93.3% (95% CI 84.0% to 94.7%, n=10, I2 99%), at 1 month, 1–6 months and ≥6 months, respectively. Differences in setting, risk of participation bias and method of assessing work absence explained some of the heterogeneity.ConclusionsPooled estimates suggest high return to work rates, with wide variation in estimates of return to work only partly explained by a priori defined study-level variables. The estimated 32% not back at work at 1 month are at a crucial point for intervention to prevent long term work absence.

Do Patients With Chronic Low Back Pain Benefit From Early Intervention Regarding Absence From Work?

“…6 No assessment of the subpopulation of people with chronic low back pain (CLBP) has been adequately performed, although several studies have emphasized that EI should be implemented to ensure early return to work (RTW). 7,8 …”

“…7,9 Therefore, it is important to reduce the length of sick leave. In this study, we sought to examine if EI for people with CLBP would lead to an early RTW and minimize sick leave during 12 months of follow-up compared with patients on a 3-month waiting list (WL).…”

Return to work with back pain: balancing the benefits of work against the efforts of being productive

“…Wynn-Jones et al 1 performed a meta-analysis of studies that followed patients with back pain and assessed if they were absent from work and, if so, for how long. They found that back pain occurs in about 15% of all patients and that 68% of these returned to work within 1 month.…”

“…Some researchers have tried to standardise the amount of sick leave days per disease as to indicate when an intervention would be needed but it has not become a very popular method. Wynne-Jones et al 1 propose to use an admittedly arbitrarily cut-off point of 1 month as being optimal for intervention. However, they admit that there is currently no evidence for an effective screening programme to target those most at risk for long-term disability.…”

The Effect of an Enhanced Rehabilitation Exercise Treatment of Non-Specific Low Back Pain- A suggestion for Rehabilitation Specialists

“…Sixty to eighty percent of grown ups will sooner or later face health predicaments with low back pain (LBP) [6,7,8], and 16% of grown ups in the United Kingdom (UK) counsel their general specialist consistently [9]. Back pain costs the National Wellbeing Administration (NHS) £1.3 million consistently [10] which causes about 12.5% of all work nonattendance in the UK [11]. Due to that, the intercession to treat nonspecific constant low back pain (NSCLBP) stays tricky [12].…”