Recurrence of Work-Related Low Back Pain and Disability

STUDY DESIGN Retrospective cohort. OBJECTIVE To explore the ability to capture low back pain (LBP) recurrence using wage-replacement (WR) data. SUMMARY OF BACKGROUND DATA LBP can be a recurrent, fluctuating, and disabling condition. Because of its largely nonspecific and subjective nature, the condition poses challenges for research and clinical management, as speaking directly with the affected individuals is not always practical. Little information is available on how indicators of LBP recurrence that can be extracted from administrative databases relate to patients' self-report. METHODS Participants with a compensated claim for work-related LBP (N = 90) were interviewed regarding their LBP-related experiences after their initial return to work. Interview data were compared with WR data, which was provided by the participants' workers' compensation provider. RESULTS Concordance was observed between WR-based indicators and self-reports of additional time off due to LBP. The best performing WR-based indicator reflected a payment history that began with more than 7 consecutive days of initial WR payments, followed by a gap in WR payments of more than 7 consecutive days, followed by another WR payment period of more than 7 consecutive days (sensitivity = 55%, specificity = 73%, overall accuracy = 69%). Although concordance was observed between the 2 measures of additional time off, the best performing WR indicator was not related to participants' other self-reports of post-return-to-work LBP recurrence which included LBP being significantly worse usual; LBP experiences; seeking health care for LBP; and the experience of difficulties related to the back condition. CONCLUSION Results indicate that compensation data can be used to capture what a claimant would self-report as additional time off after their initial return to work due to their LBP condition. However, the use of self-report recurrence indicators is recommended if there is a desire to capture a fuller extent of workers' ongoing pain and/or disability experiences. LEVEL OF EVIDENCE N/A.