Risk factors associated with the transition from acute to chronic occupational back pain

Spine (Phila Pa 1976). 2002 Jan 1;27(1):92-8. doi: 10.1097/00007632-200201010-00022.


Study design: A prospective cohort study was conducted on workers claiming earnings-related compensation for low back pain. Information obtained at the time of the initial claim was linked to compensation status (still claiming or not claiming) 3 months later.

Objective: To identify individual, psychosocial, and workplace risk factors associated with the transition from acute to chronic occupational back pain.

Summary of background data: Despite the magnitude of the economic and social costs associated with chronic occupational back pain, few prospective studies have investigated risk factors identifiable in the acute stage.

Methods: At the time of the initial compensation claim, a self-administered questionnaire was used to gather information on a wide range of risk factors. Then 3 months later, chronicity was determined from claimants' computerized records.

Results: The findings showed that 3 months after the initial assessment, 204 of the recruited 854 claimants (23.9%) still were receiving compensation payments. A combined multiple regression model of individual, psychosocial, and workplace risk factors demonstrated that severe leg pain (odds ratio [OR], 1.9), obesity (OR, 1.7), all three Oswestry Disability Index categories above minimal disability (OR, 3.1-4), a General Health Questionnaire score of at least 6 (OR, 1.9), unavailability of light duties on return to work (OR, 1.7), and a job requirement of lifting for three fourths of the day or more all were significant, independent determinants of chronicity (P < 0.05).

Conclusions: Simple self-report measures of individual, psychosocial, and workplace factors administered when earnings-related compensation for back pain is claimed initially can identify individuals with increased odds for development of chronic occupational disability.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Back Injuries / epidemiology*
  • Back Pain / epidemiology*
  • Chronic Disease
  • Cohort Studies
  • Comorbidity
  • Disability Evaluation*
  • Disease Progression
  • Female
  • Humans
  • Male
  • Middle Aged
  • New Zealand / epidemiology
  • Obesity / epidemiology
  • Occupational Diseases / epidemiology*
  • Odds Ratio
  • Predictive Value of Tests
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Surveys and Questionnaires
  • Workers' Compensation / statistics & numerical data