Early return-to-work predicts recovery from work-related acute back pain

BACKGROUND AND OBJECTIVES: It is well-accepted that an early return-to-work (RTW) after an incidence of work-related back pain is desirable. Employers pay less in disability costs and workers experience better occupational outcomes. However, less is known about the relationship between an early RTW and recovery. Advice to "stay active" has become an important element of back pain treatment, and an early RTW may provide the necessary level of activity. In a prospective cohort study, we evaluated the relationship between early RTW and 3-month pain and functional limitation. METHODS: Individuals (n=557) with recent onset of work-related low back pain completed a short questionnaire before their initial medical evaluation and then completed follow-up questionnaires at 1 and 3 months. RTW status was assessed at 1-month and outcomes, pain rating and functional limitation, were assessed at 3 months. RESULTS: In multivariate analyses, an early RTW was associated with less pain and functional limitation at 3 months (p<.05), after controlling for baseline pain and other important demographic and psychosocial predictors. Those with an immediate RTW (no lost work time) had no better outcomes than those with an early RTW (≤7 days). CONCLUSIONS: An early RTW may increase chances of recovery after an incidence of acute low back pain by ensuring sufficient activity. Further, being at work may foster functional problem-solving, provide social support, and boost self-efficacy. However, messages about early RTW may need to be delivered with care, as some individuals may view them as a cost-cutting effort on behalf of employers.