Initial patient and clinician expectations of return to work after acute onset of work-related low back pain.

Abstract

The objective of this study was to compare patient and provider expectations of return to work (RTW) after acute onset of low back pain (LBP). Workers sick-listed after onset of LBP (N = 300) completed a questionnaire about work, injury, and psychosocial disability risk factors and rated their likelihood of full RTW within 4 weeks. Clinicians provided an independent estimate of work absence, and patients were followed for 3 months. Clinician and patient expectations were weakly correlated, and both were predictive of actual RTW outcomes. Patient expectations were associated with differences in pain, mood, prior back pain, job demands, functional limitation, and marital status. Factors associated with clinician prognosis were similar but with more emphasis on physical examination findings. Even before treatment, patients may form a negative expectation for RTW that is associated with a longer duration of work absence.