Health maintenance care in work-related low back pain and its association with disability recurrence

J Occup Environ Med. 2011 Apr;53(4):396-404. doi: 10.1097/JOM.0b013e31820f3863.

Abstract

Objectives: To compare occurrence of repeated disability episodes across types of health care providers who treat claimants with new episodes of work-related low back pain (LBP).

Method: A total of 894 cases followed 1 year using workers' compensation claims data. Provider types were defined for the initial episode of disability and subsequent episode of health maintenance care.

Results: Controlling for demographics and severity, the hazard ratio [HR] of disability recurrence for patients of physical therapists (HR = 2.0; 95% confidence interval [CI] = 1.0 to 3.9) or physicians (HR = 1.6; 95% CI = 0.9 to 6.2) was higher than that of chiropractor (referent, HR = 1.0), which was similar to that of the patients non-treated after return to work (HR = 1.2; 95% CI = 0.4 to 3.8).

Conclusions: In work-related nonspecific LBP, the use of health maintenance care provided by physical therapist or physician services was associated with a higher disability recurrence than in chiropractic services or no treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cohort Studies
  • Disabled Persons / rehabilitation
  • Disabled Persons / statistics & numerical data
  • Female
  • Health Personnel / statistics & numerical data*
  • Humans
  • Injury Severity Score
  • Low Back Pain / epidemiology*
  • Low Back Pain / prevention & control
  • Low Back Pain / therapy
  • Male
  • Middle Aged
  • Physical Therapy Modalities / statistics & numerical data
  • Physicians / statistics & numerical data
  • Secondary Prevention