Prognostic factors related to recurrent low-back pain and sickness absence.
OBJECTIVE
This study aimed at determining the prognostic factors related to the recurrence of low-back pain and future sickness absence due to low-back pain.


METHODS
Data were used from a prospective cohort study in a working population with a 3-year follow-up period. They were collected with annual questionnaires. A generalized estimating equation model was used to study the relation between pain characteristics, individual characteristics, and work-related factors and the recurrence of low-back pain or sickness absence due to low-back pain in the following year. Adjustments were made for potential confounders.


RESULTS
All the pain characteristics [odds ratios (OR) varying from 1.4 to 2.4], flexion and rotation of the upper part of the body [OR 1.6, 95% confidence interval (95% CI) 1.1-2.5], low decision authority (OR 1.6, 95% CI 1.0-2.6), and low job satisfaction (OR 1.5, 95% CI 1.0-2.3), increased the risk of recurrent low-back pain. High disability due to low-back pain (OR 2.6, 95% CI 1.2-5.7), low co-worker support (OR 4.1, 95% CI 1.6-10.5), and low job satisfaction (OR 2.4, 95% CI 1.3-4.5) were predictors of sickness absence due to low-back pain. Lifting weights did not influence the risk of recurrences or sick leave.


CONCLUSIONS
According to this study, high disability due to low-back pain is a prognostic factor for recurrent low-back pain and future sickness absence due to low-back pain. In addition, the following work-related factors predict a poor prognosis of low-back pain: flexion or rotation of the trunk, low job satisfaction, low decision authority, and low social support.
van den Heuvel
Swenne G
SG
TNO Work and Employment, Hoofddorp, The Netherlands. S.vdHeuvel@arbeid.tno.nl
Ariëns
Geertje A M
GA
Boshuizen
Hendriek C
HC
Hoogendoorn
Wilhelmina E
WE
Bongers
Paulien M
PM
D000328:Adult; D000704:Analysis of Variance; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D016014:Linear Models; D017116:Low Back Pain / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis*; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D018582:Sick Leave