The impact of physical function and pain on work status at 1-year follow-up in patients with back pain

Study Design. A randomized, controlled trial. Objective. To examine the impact of physical function and pain on work status in patients who are long-term sick-listed because of back pain. Summary of Background Data. Sickness benefit is granted to a person who is incapable of working because of reduced functioning. Improved physical function and decrease of pain may be important in considering return to work. Methods. Physical performance (five activities), disability, and pain (self-reported questionnaires) were assessed at baseline and at the 1-year follow-up evaluation in 117 patients randomized to an intervention group (n = 81) and a control group (n = 36). Results. At the 1-year follow-up evaluation, 50% had returned to work. Statistically significant improvements were demonstrated from baseline to follow-up evaluation in returners to work: in the intervention group on all tests and in the control group on all except two performance tests. Improvement measures discriminated between returners and nonreturners to work in the intervention group on all physical tests and a pain test and in the control group on three physical tests and a pain test. In the intervention group, odds ratios for not having returned to work were high when test measures at follow-up indicated markedly impaired physical function and high pain; in the control group, this appeared in high pain. Conclusions. Return to work was related to physical function and pain. More importance seemed to be attributed to physical performance in the intervention group than in the controls as a basis for returning patients to work.