PATIENTS WITH LOW-BACK-PAIN NOT RETURNING TO WORK - A 12-MONTH FOLLOW-UP-STUDY

Study Design. A prospective study of patients treated with a light mob ilization program for long-term low back pain. Objectives. To examine whether medical, psychological, or social factors predict failure to r eturn to work within 12 months in the Scandinavian system of compulsor y workers' compensation and social insurance, after a light mobilizati on program administered 8-12 weeks after initial sick leave. Summary o f Background Data. The relative power of predicting factors varies in previous work, and there are no previous data on prognostic factors fo r light mobilization programs. Method. Patients (n=260) on sick leave for 8-12 weeks for low back pain were examined with a battery of psych ological and medical tests, before entering a light mobilization progr am. The treatment was given regardless of radiographic or clinical fin dings. The patients were encouraged to be active participants in the m anagement and prevention of their back pain. Their sick leave status t hen was checked through registers 12 months after they had entered the treatment program. Results. For those not returning to work within 12 months (23%), only combined models had acceptable predictive power (7 7%; discriminant analyses). Dominant variables were low Internal Healt h Locus of Control Score, restricted lateral mobility, and reduced wor k ability. The predictive value of each set of variables, taken alone, was significant only for medical variables (67% correct prediction). Conclusions. The final discriminant function may have potential as a b rief screening instrument for the number of patients with low back pai n who do not benefit from the light mobilization program.