Early prognosis for low back disability: Intervention strategies for health care providers

  • Shaw W
  • Pransky G
  • Fitzgerald T
  • 39

    Readers

    Mendeley users who have this article in their library.
  • 134

    Citations

    Citations of this article.

Abstract

PURPOSE: Disability following acute occupational low back pain (OLBP) represents a significant and preventable health outcome, yet confusion about prognostic factors have limited the development of effective, targeted interventions for those at greatest risk. The purpose of this study was to synthesize findings from available studies of prognostic factors for OLBP disability in a clinically-relevant framework.

METHOD: A systematic search of the MEDLINE database was conducted to identify empirical studies assessing the value of various prognostic factors to predict extended disability after an acute episode of OLBP. Relevant studies were screened based on a number of inclusionary criteria. Prognostic factors were catalogued, summarized, and evaluated based on agreement across studies, and clinical recommendations were developed based on the evidence.

RESULTS: Of 361 studies of OLBP disability found, 22 met specific criteria for inclusion. Significant prognostic factors included low workplace support, personal stress, shorter job tenure, prior episodes, heavier occupations with no modified duty, delayed reporting, severity of pain and functional impact, radicular findings and extreme symptom report. Physicians can decrease OLBP disability by using standardized questionnaires, improving communication with patients and employers, specifying return to work accommodations, and employing behavioural approaches to pain and disability management. Future studies should evaluate interventions guided by prognosis.

Get free article suggestions today

Mendeley saves you time finding and organizing research

Sign up here
Already have an account ?Sign in

Find this document

Authors

  • William S. Shaw

  • Glenn Pransky

  • Terence E. Fitzgerald

Cite this document

Choose a citation style from the tabs below

Save time finding and organizing research with Mendeley

Sign up for free