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Updated: Jul 17, 2026

Biomechanical Changes Related to Low Back Pain: An Innovative Tool for Movement Pattern Assessment and Treatment Evaluation in Rehabilitation
Published on: December 13, 2024
Patient clusters in acute, work-related back pain based on patterns of disability risk factors
William S Shaw1, Glenn Pransky, William Patterson
1Liberty Mutual Research Institute for Safety, Center for Disability Research, Hopkinton, Massachusetts 01748, USA. william.shaw@libertymutual.com
Objective:
To identify subgroups of patients with work-related back pain based on disability risk factors.
Methods:
Patients with work-related back pain (N = 528) completed a 16-item questionnaire of potential disability risk factors before their initial medical evaluation. Outcomes of pain, functional limitation, and work disability were assessed 1 and 3 months later.
Results:
A K-Means cluster analysis of 5 disability risk factors (pain, depressed mood, fear avoidant beliefs, work inflexibility, and poor expectations for recovery) resulted in 4 sub-groups: low risk (n = 182); emotional distress (n = 103); severe pain/fear avoidant (n = 102); and concerns about job accommodation (n = 141). Pain and disability outcomes at follow-up were superior in the low-risk group and poorest in the severe pain/fear avoidant group.
Conclusions:
Patients with acute back pain can be discriminated into subgroups depending on whether disability is related to pain beliefs, emotional distress, or workplace concerns.