Toronto • May 28-29, 2010 • Student Day and Workshops: May 27
Paper: Factors predicting recovery patterns of back pain among workers with compensated occupational back injuries
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Session : 15. Sustainable RTW (3/3)
Day/Time: Saturday at 14:00
Room: St. David Room, 3rd Floor
Objectives:
Previous research in Ontario has documented four recovery patterns of back pain among injured workers during the 12 months following a claim: Continuous high levels of pain (43%), Fluctuating pain (33%), Moderate reductions in pain (12%), and Large reductions in pain (12%).1
The objective of the current analysis is to investigate the baseline factors associated with higher probability of membership in each of these back pain groups.
Methods:
Information was collected from a cohort of workers off work because of ‘‘new’’ back injuries via structured telephone interviews. A subset of respondents (n=678) were identified with one of the above four recovery patterns based on the intensity of their back pain. Potential prognostic variables were divided into five groups: respondents’ demographics, clinical variables of back pain (e.g. Roland-Morris disability scores, physical function, mental health, nature of pain), job-related factors (e.g. physical demand of the job, firm size, industry group), respondents’ expectations of recovery and workers’ perception of their workplaces (e.g. offer of return to work from employer, perception of re-injury on return to regular job). An initial series of prognostic models of recovery patterns were examined with each group of predictors individually. A final model of the most significant prognostic factors from these five groups was fit to identify the most relevant predictors.
Results:
Older workers, or those with other health conditions, high level of disability from the injury, or those with the perception of re-injury upon return to regular job, when interviewed at baseline, had increased risk of experiencing stalled recovery represented by continuous high pain in 12 months post-injury. Those workers free of other health conditions, numbness, tingling or a cramping feeling of the back pain, or those with less severe disability were more likely to have fluctuating pain over the follow-up. Young workers were more likely to have moderate reductions in pain during the 12 months after injury.
Conclusions:
Factors in clinical diagnosis of back injuries, such as age, status of disability, nature of pain and other ongoing health conditions, were predictive of the recovery patterns from back pain that injured workers would experience. In particular, workers’ perception of high risk of re-injury at the workplace was associated with prolonged recovery. When evaluating recovery of compensated back injuries, these combined measures will be useful for health practitioners and workers’ compensation boards.
References:
1. Chen C, Hogg-Johnson S, Smith P. The recovery patterns of back pain among workers with compensated occupational back injuries. Occup Environ Med. 2007 Aug;64(8):534-40.
