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Early Return to Work Has Benefits for Relief of Back Pain and Functional Recovery After Controlling for Multiple
William S Shaw1, Candace C Nelson, Mary Jane Woiszwillo
1University of Connecticut Health Center, Farmington, Connecticut (Dr Shaw), University of Massachusetts Medical School, Worcester, Massachusetts (Dr Shaw), Liberty Mutual Research Institute for Safety, Hopkinton, Massachusetts (Dr Shaw, Dr Nelson, Ms Woiszwillo, Ms Gaines, and Dr Peters), Harvard School of Public Health, Boston, Massachusetts (Ms Nelson and Dr Peters), Massachusetts Department of Public Health, Boston, Massachusetts (Ms Nelson), University of Massachusetts, Boston, Massachusetts (Ms Gaines).
Objective:
The aim of the study was to evaluate the effect on health outcomes of an early or immediate return-to-work (RTW) after acute low back pain (LBP).
Methods:
A longitudinal cohort of workers (N = 557) consulting for uncomplicated LBP were assessed on demographic, pain, occupational, and psychosocial variables. Pain and function were assessed at 3-month postpain onset. We tested the longitudinal effects of an early RTW on 3-month outcomes.
Results:
Pain and function improved more rapidly for workers with an immediate (30.7%) or early (1 to 7 days) RTW (36.8%). Eleven demographic, health, or workplace variables were identified as potential confounds, but controlling for these factors only partially attenuated the benefits of an early RTW.
Conclusions:
An early RTW improves acute LBP and functional recovery, and alternate confounding explanations only partially eclipse this therapeutic effect.
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