DOES NONSURGICAL PAIN CENTER TREATMENT OF CHRONIC PAIN RETURN PATIENTS TO WORK - A REVIEW AND METAANALYSIS OF THE LITERATURE

Evidence in the literature relating to return to work as an outcome va riable for nonsurgical treatment for chronic pain was examined. Study selection criteria were as follows: a detailed definition of patient w ork status, delineation of work status pre-treatment and at follow-up, and documentation of the proportion of patients employed at follow-up . Of 171 studies reviewed, 37 fulfilled these selection criteria. Beca use the data were objective in nature, they were abstracted by the sen ior author only. For the coded variables of time to follow-up, proport ion of patients working pre treatment and at follow-up and number of p atients, descriptive statistics and correlations were calculated. Chan ge in employment status at follow-up was significant (P < .005) for al l groups examined. In addition, comparisons for work outcome between t reated patients versus patients rejected due to lack of insurance, and between treated patients versus patients who dropped out of treatment were both significant (P < .001). The mean difference in employment a t follow-up for treated patients versus those not treated was approxim ately 50%. The proportion of patients working increased from 20% to 54 % post chronic pain nonsurgical treatment. Correlation analyses did no t find a significant trend in percent employed with time to follow-up. These results indicate that (1) chronic pain nonsurgical treatment do es return patients to work; (2) increased rates of return to work are due to treatment, and (3) benefits of treatment are not temporary.