Low-back Pain – Predictors of Chronic Disability

Low-back pain (LBP) is the most prevalent and costly work-related condition, and most of the cost relates to the small percentage of workers with acute injuries who progress to chronic disability. Accordingly, risk factors that are early predictors of chronic disability, particularly those that can be influenced, are important.

An impressive new study at the University of Washington reports that one risk factor/predictor of chronic disability is choice of healthcare provider – and that “workers whose first health visit for the injury was to a chiropractor had substantially better outcomes”.
The percentage of those workers using chiropractic care disabled at one year was 5%, this compares with primary care (12%), occupational medicine (26%) and other (23%). Additionally, for those disabled at one year, the average number of work disability days compensated during the year was:
Provider (Average number of days of)
Chiropractor (14)
Primary care (14)
Occupational medicine (70)
Other (30)
The study offers two possibilities for the better outcomes for those consulting a chiropractor- “It is possible that workers who saw chiropractors differed in prognostically favourable ways, it is also possible that chiropractic care was more effective in improving pain and disability and/or promoting return to work.”
(Turner JA, Franklin G et al. (2008) ISSLS Prize Winner: Early Predictors of Chronic Work Disability: A Prospective, Population-Based Study of Workers with Back Injuries, Spine, 33(25):2809-2818).
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