Keeping Long-Term Back Pain Short-TermBack injuries are the most common work-related injury. Three groups have a higher than average amount of chronic back pain: nurses and nurses' aids, heavy manual workers, and drivers. In a survey from New Zealand, these three groups made up three-fourths of all workers' compensation cases of back pain.
Low back pain that doesn't last long is not what drains the pocketbook of workers, workers' compensation, and employers. It's back pain that lasts longer than three months and keeps the worker from returning to the job. About 10 percent of chronic cases cause more than 80 percent of the cost for low back pain.
The research community has placed a high value on finding out what can predict the occurrence of back pain. Being able to tell ahead of time what risk factors change acute, short-term pain into a chronic, long-term condition would be very helpful.
Risk factors for chronic pain and loss of function are divided into two major groups. These may be related to the individual worker or to the work setting. Knowing risk factors would make it possible to develop prevention programs for both the individual and the employer.
The New Zealand workers' compensation group was an ideal group to study because it has a "no-fault" system for injuries that are work-related. This removes tension between injured workers and the insurance company. The group used a simple survey to ask questions of workers with back pain. Workers were interviewed right after the initial injury. Their work status was examined three months later. The information gathered helped point out risk factors associated with the transition from acute to chronic back pain.
Individual risk factors included increasing age, obesity, the presence of severe leg pain, sleep disturbance, and depression. Risk factors in the work place included unavailability for light duties, a job that requires lifting objects for one-half of the work day, lifting or moving extremely heavy items often, and driving at least three-fourths of each day.
It is possible to predict early who will develop chronic back pain from a work-related back injury. This means it may be possible to prevent the transition from acute to chronic pain. The result would be to return workers to their workplace earlier and save money otherwise spent on medical care and disability.
Marlene Fransen, PhD, et al. Risk Factors Associated With the Transition From Acute to Chronic Occupational Back Pain. In Spine. January 1, 2002. Vol. 27. No. 1. Pp. 92-98.
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