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
The Effects of Common Medical Interventions on Pain, Back Function, and Work Resumption in Patients With Chronic Low Back Pain: A Prospective 2-Year Cohort Study in Six Countries
Study Design . A prospect i ve cohort study with identical question naires and inclusion criteria was performed . Objectives . To compare in six different countries the frequencies and effects of the common medical interventions used for patients with low back pain who are work incapacitated . Summary of Background Data . Low back pain is a huge problem with increasing costs for health care , industry , and society . Methods . Cohorts of employed men and women ages 18 to 59 years who had been sick-listed ( 100 % ) for a minimum of 90 days because of low back pain were recruited in Denmark , Germany , Israel , Sweden , the Netherl and s , and the United States . The subjects received three separate question naires with identical questions after 90 days , 1 year , and 2 years . The question naires included separate questions about background factors , treatment , and the like , as well as vali date d scales such as the Hannover Activities of Daily Living , von Korff pain score , Short Form-36 , and Karasek-Theorell . Working status was obtained from registers . Main outcome measures were working/not working , back function , and pain . Results . All three question naires were completed by 2080 subjects in the six countries . With few exceptions , there were great similarities in the appointments , examinations , and treatments in the different countries . Considerable differences were found between the back surgery rates , which ranged from 6 % in Sweden to 32 % in the United States during the first 90 days of the study . Very few of the interventions had any noticeable positive effects on work resumption , pain , or back function . Back surgery in Sweden was a striking exception , positively affecting all three outcome measures . The frequencies of work resumption within the first year ranged from 73 % in the Netherl and s to 32 % in Denmark . Conclusions . Almost none of the commonly occurring and frequently practice d medical interventions for patients who are sick-listed because of low back pain had any positive effects on either the recorded health measures or work resumption
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