Returning to Work Following Low Back Pain: Towards a Model of Individual Psychosocial Factors

• Published in: Journal of occupational rehabilitation Vol. 25; no. 1; pp. 25 - 37
• Main Authors: Besen, Elyssa, Young, Amanda E., Shaw, William S.
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.03.2015; Springer; Springer Nature B.V
• Subjects: Adolescent; Adult; Analysis; Attitude to Health; Back pain; Backache; Behavior modification; Behavior therapy; Care and treatment; Catastrophization - psychology; Clinical Psychology; Cognitive therapy; Environmental Health; Female; Health Psychology; Humans; Interpersonal Relations; Low back pain; Low Back Pain - psychology; Low Back Pain - rehabilitation; Male; Medicine; Medicine & Public Health; Middle Aged; Models, Theoretical; Occupational Medicine/Industrial Medicine; Occupational psychology; Orthopedics; Perceptions; Psychological aspects; Psychology; Rehabilitation; Return to Work - psychology; Return to Work - statistics & numerical data; Return to work programs; Secondary analysis; Social aspects; Studies; Surveys; Variables; Work-related injuries; Workers compensation; Young Adult; United States > US; Individual psychosocial factors; Fear-avoidance beliefs; Work disability prevention; Return-to-work; Recovery expectations
• ISSN: 1053-0487; 1573-3688
• DOI: 10.1007/s10926-014-9522-9

Purpose The aim of this paper is to develop and test a model of direct and indirect relationships among individual psychosocial predictors of return-to-work (RTW) outcomes following the onset of low back pain (LBP). Methods We utilize secondary analysis of a larger study of adults seeking treatment for work-related LBP with recent onset. In total, 241 participants who completed a baseline survey, a short follow-up survey, and a longer follow-up survey after 3 months were included in our analyses. The participants were required to have LBP with onset of less than 14 days, be 18 years or older, and be fluent in English or Spanish. The analyses utilized structural equation models to test the direct and indirect relationships among the variables and RTW outcomes at 3 months. Results Our results indicated a good fit for our model (χ2 = 69.59, df  = 45, p  < .05; RMSEA = .05; CFI = .95; WRMR = .61). Pain, catastrophizing, fear-avoidance beliefs, organizational support, and RTW confidence were all found to have indirect relationships with the outcomes. RTW confidence and RTW expectations were found to have direct relationships with the outcomes. Conclusions The process of returning to work after an episode of LBP is a complex process involving many interrelated factors. Understanding the relationships among critical individual factors in the RTW process may be important for the treatment and rehabilitation of those with LBP. Results suggest that if injured workers are struggling with fear avoidance, pain catastrophizing and confidence issues, they might benefit from the application of cognitive behavioral therapy techniques.