A wide range of factors-including variables related to health care and job characteristics-affect the risk of long-term disability for workers with back injuries, reports a study in the December 1 issue of Spine.
In combination, the risk factors can predict the risk of chronic disability after back injury, and may help in targeting workers for special attention to prevent disability. The lead author was Judith A. Turner, Ph.D., of University of Washington, Seattle.
The researchers performed interviews with 1,885 workers who submitted a workers' compensation claim for lost work time an average of three weeks after experiencing a back injury on the job. A wide range of factors-including medical, job-related, and psychological factors-were analyzed as possible risk factors for disability at one year after the injury.
Not surprisingly, workers with more severe back injury were more likely to be on disability after one year. Workers with pain spreading down into the leg-indicating involvement of the spinal nerve roots, or radiculopathy-were at particularly high risk.
Disability risk was also higher for workers who rated their initial disability higher, who had pain at more sites, and who had previous injuries resulting in more than one month off work. Another significant predictor was the specialty of the first doctor seen after back injury-workers who saw a chiropractor were less likely to be disabled at one year.
Certain job characteristics also affected disability risk. Risk was lower when employers offered accommodations (such as light duty) for workers recovering from back injuries. In contrast, risk was higher for workers who rated their jobs as "very hectic."
The researchers combined all of the significant factors into a statistical model for use in predicting which workers were at highest risk of long-term disability after back injury. The model was 88 percent accurate in identifying workers who would and would not be disabled after one year.