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Cited by 76Musculoskeletal pain and rehabilitationMedical Practices and RehabilitationWorkplace Health and Well-being

Expectations, perceptions, and physiotherapy predict prolonged sick leave in subacute low back pain

Open access
Reme, Silje E, Hagen, Eli M, Eriksen, Hege R·2009·BMC Musculoskeletal Disorders
DOI 10.1186/1471-2474-10-139PMC PMC2780378
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Abstract

BACKGROUND: Brief intervention programs for subacute low back pain (LBP) result in significant reduction of sick leave compared to treatment as usual. Although effective, a substantial proportion of the patients do not return to work. This study investigates predictors of return to work in LBP patients participating in a randomized controlled trial comparing a brief intervention program (BI) with BI and physical exercise. METHODS: Predictors for not returning to work was examined in 246 patients sick listed 8-12 weeks for low back pain. The patients had participated in a randomized controlled trial, with BI (n = 122) and BI + physical exercise (n = 124). There were no significant differences between the two intervention groups on return to work. The groups were therefore merged in the analyses of predictors. Multiple logistic regression analysis was used to identify predictors for non return to work at 3, 12, and 24 months of follow-up. RESULTS: At 3 months of follow-up, the strongest predictors for not returning to work were pain intensity while resting (OR = 5.6; CI = 1.7-19), the perception of constant back strain when working (OR = 4.1; CI = 1.5-12), negative expectations for return to work (OR = 4.2; CI = 1.7-10), and having been to a physiotherapist prior to participation in the trial (OR = 3.3; CI = 1.3-8.3). At 12 months, perceived reduced ability to walk far due to the complaints (OR = 2.6; CI = 1.3-5.4), pain during activities (OR = 2.4; CI = 1.1-5.1), and having been to a physiotherapist prior to participation in the trial (OR = 2.1; CI = 1.1-4.3) were the strongest predictors for non return to work. At 24 months age below 41 years (OR = 2.9; CI = 1.4-6.0) was the only significant predictor for non return to work. CONCLUSION: It appears that return to work is highly dependant on individual and cognitive factors. Patients not returning to work after the interventions were characterized by negative expectations, perceptions about pain and disability, and previous physiotherapy treatment. This is the first study reporting that previous treatment by physiotherapists is a risk factor for long-term sick leave. This has not been reported before and is an interesting finding that deserves more scrutiny.

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  • The single item measure of return-to-work expectations has been demonstrated to be a strong predictor of non-return-to-work in populations with similarities to the current study, such as people on sick leave due to chronic low back pain and people struggling with work participation due to common mental disorders.

    “This single item measure of RTW-expectations has been demonstrated to be a strong predictor of non-RTW in populations with similarities to the current, such as people on sick leave due to chronic low back pain [88], and people struggling with work participation due to common mental disorders [86].”

    From Pre- and post-operative psychological interventions to prevent pain and fatigue after breast cancer surgery (PREVENT): Protocol for a randomized controlled trial (2022) · cites this paper as [88]

    The Methods (Questionnaires) describe a single question about expected return to work, and the Results report that negative expectations strongly predicted non-return at three months (OR 4.2). But the Methods (Selection) describe participants sick-listed for 8–12 weeks with low back pain, not a chronic low-back-pain population. This citation is attached to the low-back-pain example; the separate mental-disorders example is attributed to another source. (LLM, conf=0.88)

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Research works printed but not linked: 2

  1. Hagen EM Ødelien KH Lie SA Eriksen HR Do physical exercises give additional effect on reducing sick leave for low back pain?- A 2 year follow-up study Scandinavian Journal of Public Health 2009 revised and re-submitted
  2. Hagen EM Grasdal A Eriksen HR Does early intervention with a light mobilization program reduce long-term sick leave for low back pain: a 3-year follow-up study Spine 2003 28 20 2309 2315 discussion 2316. 10.1097/01.BRS.0000085817.33211.3F 14560075 · DOI

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Authors
Reme, S. E., Hagen, E. M., & Eriksen, H. R.
Affiliations
  • University of Bergen (NO)
  • Innlandet Hospital Trust (NO)
  • Uni Research (Norway) (NO)
Corresponding author
Reme, Silje E
ORCID
Eriksen, Hege R
Venue
BMC Musculoskeletal Disorders
Publisher
Springer Science and Business Media LLC
Published
2009-11-13
Volume
10
Issue
1
Pages
139-139
ISSN
1471-2474 (ISSN-L)
DOI
10.1186/1471-2474-10-139
PMC
PMC2780378
OpenAlex
W2091010521
Cited by
76
References
52
Citations by year
2026: 1 · 2024: 3 · 2022: 4 · 2021: 7 · 2020: 4 · 2019: 4 · 2018: 2 · 2017: 8 · 2016: 6 · 2015: 3 · 2014: 8 · 2013: 12 · 2012: 6
FWCI
3.11
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Musculoskeletal Disorders (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
EkstraStiftelsen Helse og Rehabilitering (Stiftelsen Dam)
Topics
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
  • Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
Keywords
subacute low back pain, sick leave, return to work, brief intervention, physical activity, pain intensity, perceptions of disability, age as risk factor
MeSH terms
Adult, Cognition, Disability Evaluation, Female, Humans, Male, Middle Aged, Pain Measurement, Perception, Surveys and Questionnaires, Risk Factors, Severity of Illness Index, Time Factors, Logistic Models, Odds Ratio, Treatment Outcome, Low Back Pain, Risk Assessment, Sick Leave, Physical Therapy Modalities

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