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Chiropractic Research Review

Workers’ Compensation Claims for Low Back Pain

Predicting future chronic cases of low back pain (LBP) after an initial onset remains elusive, yet necessary. For example, in Quebec, Canada, 7.4% of patients with LBP lasting longer than six months accounted for 73% of medical costs and 76% of compensation for indemnity payments in 1981!

This study served to "develop a prognostic model that predicts time receiving worker's compensation benefits for low back pain claimants." Patient data from two separate databases (a clinical and an administrative database) were linked, with the subject population (claimants injured in 1994) observed for one year from the date of accident to determine cumulative number of calendar days receiving benefits.

Nearly 2,000 subjects participated in the study.

Analysis revealed eight predictive factors for time receiving workers' compensation benefits among claimants with LBP - five associated with increased time and three associated with reduced time:

Increased cumulative time:

* work in the construction industry;
* older age;
* ag time from injury to treatment;
* pain referred into the leg; and
* three or more positive nonorganic signs.

Decreased cumulative time:

* higher questionnaire score;
* intermittent pain; and
* previous episode of LBP.

The authors emphasize in their conclusion that "Clinicians should be aware of what factors differentiate claimants who become chronically disabled from those who do not," and note the value of this prognostic model in researching treatment interventions on patients at high risk of chronicity.

McIntosh G, Frank J, Hogg-Johnson S, et al. Prognostic factors for time receiving workers' compensation benefits in a cohort of patients with low back pain. Spine, Jan. 15, 2000:25(2), pp147-57.

Chiropractic Research Review

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