Comparison of risk factors predicting return to work between patients with subacute and chronic non-specific low back pain: systematic review

Abstract

The objective of the study was to provide an inventory of predictive instruments and their constituting parameters associated with return to work in patients with subacute (2-10 weeks pain duration) and chronic (10-24 weeks pain duration) non-specific low back pain (NSLBP). Data sources included systematic review in Medline, Embase, Cinahl, Central, PEDro, Psyndex, PsychInfo/PsycLit, and Sociofile up to September 2008, in reference lists of systematic reviews on risk factors, and of included studies. For the systematic review, two reviewers independently assessed study eligibility and quality, and extracted data. Disagreements were resolved by consensus. Risk factors were inventorised and grouped into a somatic and psychosocial domain. 23 studies reporting on subacute and 16 studies reporting on chronic patients were included. The studies on subacute patients reported on a total of 56 biomedical factors out of which 35 (63%) were modifiable and 61 psychosocial factors out of which 51 (84%) were modifiable. The corresponding values in studies on chronic patients were 44 biomedical [27 (62%) modifiable] and 61 [40 (66%) modifiable] respectively. Our data suggest that the interdisciplinary approach in patients at risk to develop persistent NSLBP is justified in both, the subacute and chronic disease stages. Psychosocial interventions might be more effective in subacute stages since a higher proportion of modifiable risk factors were identified in that group.

Psychosocial Work Factors and Sick Leave, Occupational Accident, and Disability Pension

“…25 Furthermore, psychosocial factors are more often modifiable than are biomedical factors. 26 Perceived psychosocial problems in the work community may cause strain to the employees and manifest as physical, mental, and social symptoms and functional disorders. Psychosocial factors, combined with physical factors, may synergistically increase the probability that an individual will leave work prematurely.…”

Supervisor Autonomy and Considerate Leadership Style are Associated with Supervisors’ Likelihood to Accommodate Back Injured Workers

“…Workers have identified the importance of a considerate, respectful supervisor when trying to RTW [13,17,22,23]. A considerate leadership style has been linked to job satisfaction, low stress, and low burnout [22,24].…”

“…Supervisors can provide modified work duties, facilitate access to medical resources, interpret corporate policies, monitor the worker's health and function, and can communicate important positive messages of support [13]. A supervisors' ability to support, show fairness, encourage autonomy and utilize a worker's skill has been shown to have a significant positive effect on the early RTW of a disabled worker [12,13].…”

Contribution of occupational factors to the incidence and persistence of chronic low back pain among workers: results from the longitudinal VISAT study

“…Thus, these authors emphasised the necessity of conducting specific studies focused on each type of LBP 13 14…”