Working with low back pain: problem-solving orientation and function

A number of ergonomic, workplace and individual psychosocial factors and he alth behaviors have been associated with the onset, exacerbation and/or mai ntenance of low back pain (LBP). The functional impact of these factors may be influenced by how a worker approaches problems in general. The present study was conducted to determine whether problem-solving orientation was as sociated with physical and mental health outcomes in fully employed workers (soldiers) reporting a history of LBP in the Fast year. The sample: consis ted of 475 soldiers (446 male, 29 female; mean age 24.5 years) who worked i n jobs identified as high risk for LBP-related disability and reported LBP symptoms in the past 12 months. The: Social Problem-Solving Inventory and t he Standard Form-12 (SF-I) were completed by all subjects. Hierarchical mul tiple regression analyses were used to predict the SF-12 physical health su mmary scale from interactions: of. LBP symptoms with each of live problem-s olving subscales. Leu; scores on positive problem-solving orientation (F(1. 457)= 4.49), and high scores on impulsivity/carelessness (F(1,457) = 9.11) were associated with a steeper gradient in functional lass related to LBP. Among those with a longer history of low-grade LBP, an avoidant approach to problem-solving was also associated with a steeper. gradient of Functional loss (three-way interaction; F(1,458) = 4.58). These results suggest that the prolonged impact of LBP on daily function may be reduced by assisting a ffected workers to conceptualize LBP as a problem that can be overcome and using strategies that promote taking an active role in reducing risks for L BP. Secondary prevention efforts may be improved by addressing these factor s. (C) 2001 International Association for the Study of Pain. Published by E lsevier Science B.V. All rights reserved.