Increased pain tolerance as an indicator of return to work in low-back injuries after work hardening

Objective. This study examined retrospective data from a multidisciplinary work-hardening program that compared patients who did and did not return to work after low-back injury. The objective of this study was to identify di fferences between these groups to better guide work-hardening programs and return-to-work decisions. Method. Retrospective data from patients with low-back injuries (n = 115) w ho participated in a northern California work-hardening program were analyz ed. Using two-way analysis of variance, male and female patients who did an d did not return to work were compared. Result. No significant differences were found between men and women for any of the variables studied. Patients who did and did not return to work were not significantly different in age, length of injury, and subjective pain at the beginning or end of the work-hardening program or in activity tolera nce (p = .08). Patients who returned to work perceived a significantly (p l ess than or equal to .05) greater improvement in pain tolerance by the end of the work-hardening program than those who did not return to work. Conclusion. The results of this study suggest that rehabilitation emphasis should not be placed on the reduction of subjective pain but, rather, on st rategies to cope with existing pain while improving functional ability.