Risk factors for recurrent episodes of care and work disability: case of low back pain

J Occup Environ Med. 2004 Jan;46(1):68-76. doi: 10.1097/01.jom.0000105987.32375.3d.


Recurrences of injuries are common and have significant socioeconomic consequences; it is important to identify associated risk factors as potential opportunities for prevention. This study was conducted to identify risk factors for low back pain (LBP) recurrence and the extent that variation in recurrence definition impacts identified risk factors. Patients with new claims for LBP reported in New Hampshire to a workers' compensation provider were selected (n = 2023) with a minimum of 3-year follow up. Alternative definitions of recurrence included a new episode of medical care and a new episode of lost work time (work disability). Risk factors better predicted disability-based than treatment-based recurrence. Longer durations of the initial episode of care or work disability were the most powerful predictors of recurrence, implying that shorter episodes of care and early return to work contribute to better outcomes.

MeSH terms

  • Adult
  • Disability Evaluation*
  • Female
  • Humans
  • Low Back Pain / prevention & control*
  • Low Back Pain / rehabilitation
  • Low Back Pain / therapy
  • Male
  • New Hampshire
  • Risk Factors
  • Secondary Prevention
  • Sick Leave / statistics & numerical data
  • Work Capacity Evaluation
  • Workers' Compensation / statistics & numerical data