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Biomechanical Changes Related to Low Back Pain: An Innovative Tool for Movement Pattern Assessment and Treatment Evaluation in Rehabilitation

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Published on: December 13, 2024

Prognostic factors for return to work in patients with sciatica.

Lars Grøvle¹, Anne J Haugen, Anne Keller

¹Department of Rheumatology, Østfold Hospital Trust, Postboks 16, 1603 Fredrikstad, Norway.

The Spine Journal : Official Journal of the North American Spine Society

|September 25, 2013

Summary

This summary is machine-generated.

Prognostic factors for return to work (RTW) in sciatica patients include age, general health, and pain bothersomeness. Surgical treatment was linked to slower RTW, but this requires cautious interpretation due to patient severity.

Keywords:

Fear-avoidance beliefs Prognosis Return to work Sciatica Sickness absence

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Area of Science:

Orthopedics
Occupational Health
Rehabilitation Medicine

Background:

Prognostic factors for work-related outcomes in sciatica due to disc herniation are not well understood.
Identifying these factors is crucial for improving return to work (RTW) rates.

Purpose of the Study:

To identify prognostic factors for RTW in sciatica patients referred to secondary care.
To analyze these factors over a 2-year follow-up period.

Main Methods:

A multicenter prospective cohort study involving 466 sciatica patients.
Two samples were analyzed: one based on self-reported work status and another using national sickness benefit register data.
Multivariate logistic regression and Cox proportional hazard modeling were used to identify predictors of RTW, adjusting for age and sex.

Main Results:

Younger age, better general health, lower pain bothersomeness, less fear-avoidance of work, and a negative straight-leg-raising test were associated with higher RTW probability in Sample A.
In Sample B, history of sciatica, longer episode duration (>3 months), greater pain bothersomeness, fear-avoidance of work, and back pain were linked to longer time to sustained RTW.
Surgery was not significantly associated with RTW in Sample A but was negatively associated with time to sustained RTW in Sample B (HR 0.49).

Conclusions:

Key baseline predictors for RTW include age, general health, sciatica history, episode duration, pain severity, fear-avoidance, back pain, and straight-leg-raising test results.
Surgical treatment showed an association with slower RTW, though this finding needs careful consideration due to potential confounding by patient severity.