Patient clusters in acute, work-related back pain based on patterns of disability risk factors

J Occup Environ Med. 2007 Feb;49(2):185-93. doi: 10.1097/01.jom.0000254205.47334.c3.


Objective: To identify subgroups of patients with work-related back pain based on disability risk factors.

Methods: Patients with work-related back pain (N = 528) completed a 16-item questionnaire of potential disability risk factors before their initial medical evaluation. Outcomes of pain, functional limitation, and work disability were assessed 1 and 3 months later.

Results: A K-Means cluster analysis of 5 disability risk factors (pain, depressed mood, fear avoidant beliefs, work inflexibility, and poor expectations for recovery) resulted in 4 sub-groups: low risk (n = 182); emotional distress (n = 103); severe pain/fear avoidant (n = 102); and concerns about job accommodation (n = 141). Pain and disability outcomes at follow-up were superior in the low-risk group and poorest in the severe pain/fear avoidant group.

Conclusions: Patients with acute back pain can be discriminated into subgroups depending on whether disability is related to pain beliefs, emotional distress, or workplace concerns.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living / psychology
  • Adolescent
  • Adult
  • Aged
  • Back Injuries / complications*
  • Back Injuries / psychology
  • Back Pain / epidemiology
  • Back Pain / etiology*
  • Back Pain / psychology
  • Cluster Analysis
  • Disability Evaluation*
  • Fear
  • Female
  • Health Surveys
  • Humans
  • Male
  • Middle Aged
  • Occupational Diseases / classification*
  • Occupational Diseases / epidemiology
  • Occupational Diseases / etiology
  • Pain
  • Pain Measurement / methods
  • Pain Measurement / psychology
  • Risk Factors
  • Surveys and Questionnaires