The Association of First Provider Seen With Time Loss From Work Among Workers With Back Injury: A Cohort Study

Area of Science:

• Occupational health
• Musculoskeletal disorders
• Health services research

Background:

• Prior research suggests chiropractors may offer better outcomes for back pain than primary care physicians.
• However, studies often lack adjustment for confounders and focus on work-related outcomes.

Purpose of the Study:

• To investigate the association between initiating care with a chiropractor versus a primary care physician for work-related back injuries.
• To evaluate the impact on long-term work disability outcomes.

Main Methods:

• Population-based prospective cohort study of workers' compensation claimants.
• Logistic regression analysis adjusted for numerous confounders.
• E-value used to assess unmeasured confounding.

Main Results:

• 44.4% of participants initiated care with a chiropractor.
• Chiropractor group had significantly lower odds of receiving temporary total disability (time loss) benefits at 1 year (aOR 0.45).

Conclusions:

• Initiating chiropractic care for work-related back injuries is associated with reduced long-term time loss compensation.
• This association persists after comprehensive adjustment for patient and injury characteristics.