Occupational lower-back injuries in a primary medical care setting: a five-year follow-up study

A cohort study with follow-up that describes the clinical characteristics and outcome five years later of patients with new occupational lower-back injuries, who were seen at a primary-care occupational health clinic in 1979, is presented. Follow-up data were obtained for 119 cases, 63% of all eligible cases. Occupational lower-back injuries constituted 9.5% of new occupational injuries that were seen at the clinic. Men aged less than 50 years accounted for 82% of all cases, and lifting was the most common method of injury. Forty-three per cent of patients were able to return to alternative duties without any absence from work and the majority (82%) of patients had returned to work in fewer than five days. Between 1979 and 1984, 48% of those studied had experienced recurrences of occupational lower-back injury that required medical treatment; half these recurrences occurred on more than three occasions. At five-year follow-up, 93% of patients were in work, although 70% of respondents stated they were still suffering back pain. Fewer than one-third of patients were receiving medical or other treatment at the time of follow-up. Only 2% of patients had undergone surgery and only 8% of patients were engaged in legal action in pursuit of a workers' compensation claim. This primary medical-care study challenges a number of popular stereotypes concerning occupational back injuries.