Low Back Pain and Returning to Work

Low back pain (LBP) sufferers realize that it is not realistic to go back to work until a physician has written permission to return to work (RTW).  There is sufficient evidence that 90 percent of patients with attacks of LBP will recover within 6 weeks regardless of the treatment.

Many studies have been done to find treatment that will make recovering from LBP much quicker.  A team of physicians set out to review the available literature regarding LBP and RTW.  Ten studies met their strict criteria for review.  The goal was to see if recovery from LBP would happen more quickly with certain types of treatment.

The various types of treatment studied included "back school" (teaching one to use the back properly when lifting, etc.), physical therapy and exercise, spinal manipulation (osteopathic or chiropractic), and bed rest.

The authors of this review concluded that there is very little known regarding how to help patients with LBP recover more quickly and return to work.  They suggested that there is a psychological component involved: if you love your job and really want to get back to work quickly, you are more likely to respond to treatment.  They stated that bed rest for a brief period (1 to 3 days) is reasonable as long as the LBP isn't from something like a "slipped" disc or some other neurological disorder. 

Exercise, back school, and PT have all shown promise in helping to prevent recurrence of LBP but were not shown to expedite recovery of a current attack.  The authors suggested that spinal manipulation needed further study before it could be evaluated.  They did not comment on the use of pain medications or muscle relaxants.

For further information, see: "Randomized Controlled Trials in Industrial Low Back Pain Relating to Return to Work.  Part 1. Acute Interventions," Scheer, S MD; Radack, K MD; O'Brien, D Jr MD, Archives of Physical Medicine and Rehabilitation.