C. Infanterivard et M. Lortie, RELAPSE AND SHORT SICKNESS ABSENCE FOR BACK PAIN IN THE 6 MONTHS AFTER RETURN TO WORK, Occupational and environmental medicine, 54(5), 1997, pp. 328-334
Objectives--To measure the incidence of back pain relapse (causing thr
ee consecutive days off work on medical advice) and of short sickness
absence (less than three consecutive days), and to determine whether t
he incidence of such events was affected by overall pain and specific
pain related to simple daily movements (functional capacity) assessed
at discharge. Methods--A cohort of workers with a first compensated ep
isode of back pain was prospectively followed up from return to work a
fter rehabilitative treatment. Follow up among 230 workers was carried
out monthly by phone for a maximum of six months. Crude and adjusted
rate ratios (RRs) along with 95% confidence intervals (95% CIs) were e
stimated with the Cox's proportional hazards model. Results--Within si
x months of return to work, 29 workers (12.6%) had relapsed, and anoth
er 15 workers (6.5%) had a short sickness absence. 50% of relapses had
occurred within 42 days of return to work whereas this figure was 28
days for short sickness absence. In a multivariate model that consider
ed pain and clinical variables at discharge only a scale combining all
pain variables (specific daily movements as well as the visual analog
overall pain scale) contributed to relapse and short sickness absence
as the outcome (RR (95% CI)) (1.53 (0.96-2.43)); the same was true in
a model considering pain and workers' views on desired changes to wor
k conditions (1.60; 1.08 to 2.36). Conclusions--Incidence of relapse o
r short sickness absence in the first six months after return to work
was 19.1%. Of all measured prognostic (sociodemographic, clinical, vie
ws, and pain), only overall pain and pain associated with carrying out
simple daily movements were helpful in predicting relapse or short si
ckness absence.