title: Increased pain tolerance as an indicator of return to work in low-back injuries after work hardening.
abstract: OBJECTIVE
  This study examined retrospective data from a multidisciplinary work-hardening program that compared patients who did and did not return to work after low-back injury. The objective of this study was to identify differences between these groups to better guide work-hardening programs and return-to-work decisions.
  
  
  METHODS
  Retrospective data from patients with low-back injuries (n = 115) who participated in a northern California work-hardening program were analyzed. Using two-way analysis of variance, male and female patients who did and did not return to work were compared.
  
  
  RESULTS
  No significant differences were found between men and women for any of the variables studied. Patients who did and did not return to work were not significantly different in age, length of injury, and subjective pain at the beginning or end of the work-hardening program or in activity tolerance (p = .08). Patients who returned to work perceived a significantly (p < or = . 05) greater improvement in pain tolerance by the end of the work-hardening program than those who did not return to work.
  
  
  CONCLUSIONS
  The results of this study suggest that rehabilitation emphasis should not be placed on the reduction of subjective pain but, rather, on strategies to cope with existing pain while improving functional ability.
authors.affiliation: Fit-to-Work Rehabilitation Clinic, Cameron Park, California, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Joy
authors.forename: J
authors.initials: J
authors.lastname: Lowy
authors.forename: J K
authors.initials: JK
authors.lastname: Mansoor
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000145:classification* / Q000534:rehabilitation*; D008159:Lumbar Vertebrae / Q000293:injuries; D008297:Male; D009784:Occupational Diseases / Q000534:rehabilitation*; D010147:Pain Measurement; D017288:Pain Threshold; D011336:Probability; D012042:Registries; D012050:Rehabilitation, Vocational / Q000379:methods*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014940:Work Schedule Tolerance / Q000502:physiology*