Prognostic factors related to recurrent low-back pain and sickness absence

Scand J Work Environ Health. 2004 Dec;30(6):459-67. doi: 10.5271/sjweh.835.


Objectives: This study aimed at determining the prognostic factors related to the recurrence of low-back pain and future sickness absence due to low-back pain.

Methods: Data were used from a prospective cohort study in a working population with a 3-year follow-up period. They were collected with annual questionnaires. A generalized estimating equation model was used to study the relation between pain characteristics, individual characteristics, and work-related factors and the recurrence of low-back pain or sickness absence due to low-back pain in the following year. Adjustments were made for potential confounders.

Results: All the pain characteristics [odds ratios (OR) varying from 1.4 to 2.4], flexion and rotation of the upper part of the body [OR 1.6, 95% confidence interval (95% CI) 1.1-2.5], low decision authority (OR 1.6, 95% CI 1.0-2.6), and low job satisfaction (OR 1.5, 95% CI 1.0-2.3), increased the risk of recurrent low-back pain. High disability due to low-back pain (OR 2.6, 95% CI 1.2-5.7), low co-worker support (OR 4.1, 95% CI 1.6-10.5), and low job satisfaction (OR 2.4, 95% CI 1.3-4.5) were predictors of sickness absence due to low-back pain. Lifting weights did not influence the risk of recurrences or sick leave.

Conclusions: According to this study, high disability due to low-back pain is a prognostic factor for recurrent low-back pain and future sickness absence due to low-back pain. In addition, the following work-related factors predict a poor prognosis of low-back pain: flexion or rotation of the trunk, low job satisfaction, low decision authority, and low social support.

MeSH terms

  • Adult
  • Analysis of Variance
  • Cohort Studies
  • Disability Evaluation*
  • Female
  • Humans
  • Linear Models
  • Low Back Pain / diagnosis*
  • Low Back Pain / epidemiology
  • Low Back Pain / etiology
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Occupational Exposure / adverse effects
  • Occupational Exposure / analysis*
  • Prognosis
  • Prospective Studies
  • Recurrence
  • Risk Factors
  • Sick Leave*