Work-related chronic low back pain-return-to-work outcomes after referral to interventional pain and spine clinics

Spine (Phila Pa 1976). 2012 Sep 15;37(20):E1282-9. doi: 10.1097/BRS.0b013e318265a930.

Abstract

Study design: A retrospective cohort study.

Objective: To evaluate return-to-work outcomes in patients with chronic, work-related low back pain referred to pain treatment centers and/or spine clinics (PTCs/SCs).

Summary of background data: Return-to-work outcomes in cases of work-related chronic low back pain after referral to PTCs and/or SCs have not been previously studied.

Methods: A retrospective chart review of 230 consecutive patients was conducted from an occupational medicine program. Of these, 122 patients were referred to a PTC/SC and 108 patients were not. Multivariate logistic regression was used to develop a model to predict improvement in functional status and pain level after 1 year.

Results: At the 1-year evaluation, there was functional improvement in the nonreferral group (P < 0.001) and no change in the referral group (P = 0.21). The change in pain level was similar. Time from injury to initial evaluation seemed to be the major factor contributing to poor outcomes in both groups.

Conclusion: Referral to a PTC/SC did not yield improved functional outcomes in this cohort. A major factor contributing to this finding was the length of time to referral to PTC/SC after the initial injury.

MeSH terms

  • Adult
  • Chronic Disease
  • Disability Evaluation
  • Female
  • Humans
  • Logistic Models
  • Low Back Pain / physiopathology
  • Low Back Pain / rehabilitation*
  • Male
  • Manipulation, Chiropractic / statistics & numerical data*
  • Middle Aged
  • Multivariate Analysis
  • Occupational Diseases / physiopathology
  • Occupational Diseases / rehabilitation*
  • Outcome Assessment, Health Care / statistics & numerical data
  • Pain Clinics / statistics & numerical data*
  • Pain Measurement
  • Recovery of Function
  • Referral and Consultation / statistics & numerical data*
  • Retrospective Studies
  • Return to Work / statistics & numerical data*
  • Time Factors
  • Workers' Compensation / statistics & numerical data