C.S.I. Reference Articles

Patterns of sick-leave and health outcomes in injured workers with back pain

10:29 AM PST - 5/5/2008
by: Terry Weyman, D.C., C.C.S.P.

From Foundation for Chiropractic Education and Research
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Volume 14, Number 30 * * April 29, 2008
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Patterns of sick-leave and health outcomes in injured workers with back pain

Little is known about the sick-leave experiences of workers who make a workers’ compensation
claim for back pain. Our objective is to describe the 1-year patterns of sick-leave and the health
outcomes of a cohort of workers who make a workers’ compensation claim for back pain. We
studied a cohort of 1,831 workers from five large US firms who made incident workers’
compensation claims for back pain between January 1, 1999 and June 30, 2002. Injured workers
were interviewed 1 month (n = 1,321), 6 months (n = 810) and 1 year (n = 462) following the
onset of their pain. We described the course of back pain using four patterns of sick-leave: (1) no
sick-leave, (2) returned to worked and stayed, (3) multiple episodes of sick-leave and (4) not yet
returned to work. We described the health outcomes as back and/or leg pain intensity, functional
limitations and health-related quality of life. We analyzed data from participants who completed all
follow-up interviews (n = 457) to compute the probabilities of transition between patterns of sickleave.
A significant proportion of workers experienced multiple episodes of sick-leave (30.2%;
95% CI 25.0–35.1) during the 1-year follow-up. The proportion of workers who did not report sickleave
declined from 42.4% (95% CI 39.0–46.1) at 1 month to 33.6% (28.0–38.7) at 1 year. One
year after the injury, 2.9% (1.6–4.9) of workers had not yet returned to work. Workers who did not
report sick-leave and those who returned and stayed at work reported better health outcomes
than workers who experienced multiple episodes of sick-leave or workers who had not returned to
work. Almost a third of workers with an incident episode of back pain experience recurrent spells
of work absenteeism during the following year. Our data suggest that stable patterns of sick-leave
are associated with better health.
Cote P, et al. European Spine Journal. April 2008; Vol. 17, No. 4, pp. 484-493.

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