The following factors were found to have consistent , but limited , support as regards their influence on the risk for sick leave due to back and neck disorders : ( a ) heavy physical workload , bent or twisted working position , and low work satisfaction increases the risk for short-term and long-term sick leave ; ( b ) specific back diagnoses and previous sick leave due to back disorders increases the risk for short-term and long-term sick leave ; ( c ) female gender , smoking , exposure to vibration , and deficient social support were not found to significantly increase the risk for short-term and long-term sick leave ; ( d ) self-reported pain and functional impairments were associated with a high risk for long-term sick leave ; ( e ) longer employment periods reduced the risk for short-term sick leave ; ( f ) perceived dem and s at work did not influence short-term sick leave ; ( g ) female gender and higher age increases the risk for disability pension
Clinical Management and the Duration of Disability for Work-Related Low Back Pain
Clinical practice guidelines recommend a conservative approach to management of acute low back pain ( LBP ) . The present study sought to determine whether health care utilization and the physician ’s initial management of work-related LBP were associated with disability duration . Clinical management information was obtained for 98 r and omly selected , workers ’ compensation cl aim ants with acute , uncomplicated , disabling work-related LBP .  Length of disability was based on indemnity ( wage replacement ) payments . Disability was significantly associated with increased utilization of specialty referrals ( P = 0.013 ) and provider visits ( P < 0.001 ) , use of magnetic resonance imaging ( P = 0.003 ) , and use of  opioids for more than 7 days ( P = 0.013 ) . Effects of early diagnostic imaging ( first 30 days of care ) on length of disability were observed ( P = 0.001 ) . Patients whose treatment course did not involve extended opioid use and early diagnostic testing were 3.78 times more likely ( 95 % confidence interval , 1.6 to 8.9 ) to have gone off disability status by the end of the study . The nature of the association between these initial clinical management aspects and LBP disability duration merits further exploration
The following factors were found to have consistent , but limited , support as regards their influence on the risk for sick leave due to back and neck disorders : ( a ) heavy physical workload , bent or twisted working position , and low work satisfaction increases the risk for short-term and long-term sick leave ; ( b ) specific back diagnoses and previous sick leave due to back disorders increases the risk for short-term and long-term sick leave ; ( c ) female gender , smoking , exposure to vibration , and deficient social support were not found to significantly increase the risk for short-term and long-term sick leave ; ( d ) self-reported pain and functional impairments were associated with a high risk for long-term sick leave ; ( e ) longer employment periods reduced the risk for short-term sick leave ; ( f ) perceived dem and s at work did not influence short-term sick leave ; ( g ) female gender and higher age increases the risk for disability pension