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Predictors of stable return-to-work in non-acute , non-specific spinal pain : low total prior sick-listing , high self prediction and young age . A two-year prospective cohort study . BACKGROUND Non-specific spinal pain ( NSP ) , comprising back and/or neck pain , is one of the leading disorders in long-term sick-listing . During 2000-2004 , 125 Swedish primary-care patients with non-acute NSP , full-time sick-listed 6 weeks-2 years , were included in a randomized controlled trial to compare a cognitive-behavioural programme with traditional primary care . This prospective cohort study is a re-assessment of the data from the randomized trial with the 2 treatment groups considered as a single cohort . The aim was to investigate which baseline variables predict a stable return-to-work during a 2-year period after baseline : objective variables from function tests , socioeconomic , subjective and/or treatment variables . Stable return-to-work was a return-to-work lasting for at least 1 month from the start of follow-up . METHODS Stable return-to-work was the outcome variable , the above-mentioned factors were the predictive variables in multiple-logistic regression models , one per follow-up at 6 , 12 , 18 and 24 months after baseline . The factors from univariate analyzes with a p-value of at most .10 were included . The non-significant variables were excluded stepwise to yield models comprising only significant factors ( p < .05 ) . As the comparatively few cases made it risky to associate certain predictors with certain time-points , we finally considered the predictors which were represented in at least 3 follow-ups . They are presented with odds ratios ( OR ) and 95 % confidence intervals . RESULTS Three variables qualified , all of them represented in 3 follow-ups : Low total prior sick-listing ( including all diagnoses ) was the strongest predictor in 2 follow-ups , 18 and 24 months , OR 4.8 [ 1.9-12.3 ] and 3.8 [ 1.6-8.7 ] respectively , High self prediction ( the patients ' own belief in return-to-work ) was the strongest at 12 months , OR 5.2 [ 1.5-17.5 ] and Young age ( max 44 years ) the second strongest at 18 months , OR 3.5 [ 1.3-9.1 ] . CONCLUSIONS In primary-care patients with non-acute NSP , the strong predictors of stable return-to-work were 2 socioeconomic variables , Low total prior sick-listing and Young age , and 1 subjective variable , High self-prediction . Objective variables from function tests and treatment variables were non-predictors . Except for Young age , the predictors have previously been insufficiently studied , and so our study should widen knowledge within clinical practice .
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Intervention_Physical
stable return-to-work
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Intervention_Psychological
cognitive-behavioural programme
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Intervention_Educational
with traditional primary care .
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Intervention_Physical
stable return-to-work
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Outcome_Other
Low total prior sick-listing ( including all diagnoses )
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Outcome_Other
strongest predictor
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Outcome_Other
High self prediction
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Outcome_Physical
Young age
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Participant_Condition
Non-specific spinal pain ( NSP )
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Participant_Condition
back and/or neck pain
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Participant_Sample-size
125
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Participant_Condition
non-acute NSP
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Participant_Condition
non-acute NSP