Recurrent disabling work-related spinal disorders after prior injury claims in a chronic low back pain population

Trent H. Evans, Tom G. Mayer, Robert Joseph Gatchel

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Background context: Multiple compensation injury claims are an understudied phenomenon in the chronic back pain and occupational injury literature. Assumptions about poor treatment outcomes for patients presenting with prior injury can lead to denial of treatment, even though these assumptions have not been empirically addressed. Functional restoration has been demonstrated to be an effective rehabilitation treatment for disabling, work-related chronic back pain, although its' relative utility with recurrent injury (RI) patients has not been previously evaluated. Purpose: To assess demographic, psychosocial and work history/adjustment differences between the two groups, and to investigate whether patients with recurrent work-related spinal injury claims benefit from functional restoration treatment at a level equivalent to patients with nonrecurrent injuries. Study design/setting: A prospective cohort design assessing characteristics and outcomes of patients with recurrent work-related spinal disorders, compared with a group of patients without prior work-related spine injury claims, all treated with the same interdisciplinary rehabilitation protocol. Patient sample: A cohort of consecutively treated functional restoration rehabilitation patients (n=395) divided into two groups based on a history of prior work-related injury. The RI (n=172) group had at least one prior work-related injury claim (with or without lost time), whereas the nonrecurrent injury (NRI; n=223) group did not. Outcome measures: The RI and NRI groups were assessed for prospectively collected demographic, psychosocial and work history/adjustment data. A structured clinical interview addressing socioeconomic outcomes and assessing work return, health utilization, recurrent injury and case closure was administered 1 year after discharge from the treatment program. Methods: Consecutive patients from a regional referral center for tertiary rehabilitation treatment of chronic work-related musculoskeletal injuries were evaluated with a comprehensive biopsychosocial assessment protocol at pretreatment and posttreatment. Moreover, at 1 year after completing the program, a structural telephone interview was conducted that assessed health and socioeconomic outcomes. Results: For the 1-year socioeconomic outcomes (such as posttreatment injury), the RI patients responded to rehabilitation at a level equivalent to the NRI patients. Demographic analyses revealed that RI patients, relative to NRI patients, were older, more represented by the dominant culture, had more education, had a shorter length of disability, had less severe types of injuries, had a greater rate of non-work-related health conditions, received higher disability payments, and had slightly greater job demand. The RI group also had a greater rate of pre-injury Axis I psychiatric disorders, particularly substance abuse/dependence disorders, than the NRI group. In addition, the RI group had greater job stability than the NRI group.

Original languageEnglish
Pages (from-to)183-189
Number of pages7
JournalSpine Journal
Volume1
Issue number3
DOIs
StatePublished - 1 May 2001

Fingerprint

Low Back Pain
Wounds and Injuries
Population
Rehabilitation
Demography
Back Pain
Chronic Pain
Substance-Related Disorders
Health
Back Injuries
Interviews
Occupational Injuries
Therapeutics
Spinal Injuries
Multiple Trauma
Tertiary Care Centers

Keywords

  • Chronic pain
  • Chronic spinal disorders
  • Claims
  • Compensation injuries
  • Functional restoration
  • Outcomes
  • Recurrent injury
  • Tertiary rehabilitation
  • Workers' compensation

Cite this

Evans, Trent H. ; Mayer, Tom G. ; Gatchel, Robert Joseph. / Recurrent disabling work-related spinal disorders after prior injury claims in a chronic low back pain population. In: Spine Journal. 2001 ; Vol. 1, No. 3. pp. 183-189.
@article{dc7b96daa5f7499bae5abd3cc36b24ea,
title = "Recurrent disabling work-related spinal disorders after prior injury claims in a chronic low back pain population",
abstract = "Background context: Multiple compensation injury claims are an understudied phenomenon in the chronic back pain and occupational injury literature. Assumptions about poor treatment outcomes for patients presenting with prior injury can lead to denial of treatment, even though these assumptions have not been empirically addressed. Functional restoration has been demonstrated to be an effective rehabilitation treatment for disabling, work-related chronic back pain, although its' relative utility with recurrent injury (RI) patients has not been previously evaluated. Purpose: To assess demographic, psychosocial and work history/adjustment differences between the two groups, and to investigate whether patients with recurrent work-related spinal injury claims benefit from functional restoration treatment at a level equivalent to patients with nonrecurrent injuries. Study design/setting: A prospective cohort design assessing characteristics and outcomes of patients with recurrent work-related spinal disorders, compared with a group of patients without prior work-related spine injury claims, all treated with the same interdisciplinary rehabilitation protocol. Patient sample: A cohort of consecutively treated functional restoration rehabilitation patients (n=395) divided into two groups based on a history of prior work-related injury. The RI (n=172) group had at least one prior work-related injury claim (with or without lost time), whereas the nonrecurrent injury (NRI; n=223) group did not. Outcome measures: The RI and NRI groups were assessed for prospectively collected demographic, psychosocial and work history/adjustment data. A structured clinical interview addressing socioeconomic outcomes and assessing work return, health utilization, recurrent injury and case closure was administered 1 year after discharge from the treatment program. Methods: Consecutive patients from a regional referral center for tertiary rehabilitation treatment of chronic work-related musculoskeletal injuries were evaluated with a comprehensive biopsychosocial assessment protocol at pretreatment and posttreatment. Moreover, at 1 year after completing the program, a structural telephone interview was conducted that assessed health and socioeconomic outcomes. Results: For the 1-year socioeconomic outcomes (such as posttreatment injury), the RI patients responded to rehabilitation at a level equivalent to the NRI patients. Demographic analyses revealed that RI patients, relative to NRI patients, were older, more represented by the dominant culture, had more education, had a shorter length of disability, had less severe types of injuries, had a greater rate of non-work-related health conditions, received higher disability payments, and had slightly greater job demand. The RI group also had a greater rate of pre-injury Axis I psychiatric disorders, particularly substance abuse/dependence disorders, than the NRI group. In addition, the RI group had greater job stability than the NRI group.",
keywords = "Chronic pain, Chronic spinal disorders, Claims, Compensation injuries, Functional restoration, Outcomes, Recurrent injury, Tertiary rehabilitation, Workers' compensation",
author = "Evans, {Trent H.} and Mayer, {Tom G.} and Gatchel, {Robert Joseph}",
year = "2001",
month = "5",
day = "1",
doi = "10.1016/S1529-9430(01)00079-1",
language = "English",
volume = "1",
pages = "183--189",
journal = "Spine Journal",
issn = "1529-9430",
publisher = "Elsevier Inc.",
number = "3",

}

Recurrent disabling work-related spinal disorders after prior injury claims in a chronic low back pain population. / Evans, Trent H.; Mayer, Tom G.; Gatchel, Robert Joseph.

In: Spine Journal, Vol. 1, No. 3, 01.05.2001, p. 183-189.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Recurrent disabling work-related spinal disorders after prior injury claims in a chronic low back pain population

AU - Evans, Trent H.

AU - Mayer, Tom G.

AU - Gatchel, Robert Joseph

PY - 2001/5/1

Y1 - 2001/5/1

N2 - Background context: Multiple compensation injury claims are an understudied phenomenon in the chronic back pain and occupational injury literature. Assumptions about poor treatment outcomes for patients presenting with prior injury can lead to denial of treatment, even though these assumptions have not been empirically addressed. Functional restoration has been demonstrated to be an effective rehabilitation treatment for disabling, work-related chronic back pain, although its' relative utility with recurrent injury (RI) patients has not been previously evaluated. Purpose: To assess demographic, psychosocial and work history/adjustment differences between the two groups, and to investigate whether patients with recurrent work-related spinal injury claims benefit from functional restoration treatment at a level equivalent to patients with nonrecurrent injuries. Study design/setting: A prospective cohort design assessing characteristics and outcomes of patients with recurrent work-related spinal disorders, compared with a group of patients without prior work-related spine injury claims, all treated with the same interdisciplinary rehabilitation protocol. Patient sample: A cohort of consecutively treated functional restoration rehabilitation patients (n=395) divided into two groups based on a history of prior work-related injury. The RI (n=172) group had at least one prior work-related injury claim (with or without lost time), whereas the nonrecurrent injury (NRI; n=223) group did not. Outcome measures: The RI and NRI groups were assessed for prospectively collected demographic, psychosocial and work history/adjustment data. A structured clinical interview addressing socioeconomic outcomes and assessing work return, health utilization, recurrent injury and case closure was administered 1 year after discharge from the treatment program. Methods: Consecutive patients from a regional referral center for tertiary rehabilitation treatment of chronic work-related musculoskeletal injuries were evaluated with a comprehensive biopsychosocial assessment protocol at pretreatment and posttreatment. Moreover, at 1 year after completing the program, a structural telephone interview was conducted that assessed health and socioeconomic outcomes. Results: For the 1-year socioeconomic outcomes (such as posttreatment injury), the RI patients responded to rehabilitation at a level equivalent to the NRI patients. Demographic analyses revealed that RI patients, relative to NRI patients, were older, more represented by the dominant culture, had more education, had a shorter length of disability, had less severe types of injuries, had a greater rate of non-work-related health conditions, received higher disability payments, and had slightly greater job demand. The RI group also had a greater rate of pre-injury Axis I psychiatric disorders, particularly substance abuse/dependence disorders, than the NRI group. In addition, the RI group had greater job stability than the NRI group.

AB - Background context: Multiple compensation injury claims are an understudied phenomenon in the chronic back pain and occupational injury literature. Assumptions about poor treatment outcomes for patients presenting with prior injury can lead to denial of treatment, even though these assumptions have not been empirically addressed. Functional restoration has been demonstrated to be an effective rehabilitation treatment for disabling, work-related chronic back pain, although its' relative utility with recurrent injury (RI) patients has not been previously evaluated. Purpose: To assess demographic, psychosocial and work history/adjustment differences between the two groups, and to investigate whether patients with recurrent work-related spinal injury claims benefit from functional restoration treatment at a level equivalent to patients with nonrecurrent injuries. Study design/setting: A prospective cohort design assessing characteristics and outcomes of patients with recurrent work-related spinal disorders, compared with a group of patients without prior work-related spine injury claims, all treated with the same interdisciplinary rehabilitation protocol. Patient sample: A cohort of consecutively treated functional restoration rehabilitation patients (n=395) divided into two groups based on a history of prior work-related injury. The RI (n=172) group had at least one prior work-related injury claim (with or without lost time), whereas the nonrecurrent injury (NRI; n=223) group did not. Outcome measures: The RI and NRI groups were assessed for prospectively collected demographic, psychosocial and work history/adjustment data. A structured clinical interview addressing socioeconomic outcomes and assessing work return, health utilization, recurrent injury and case closure was administered 1 year after discharge from the treatment program. Methods: Consecutive patients from a regional referral center for tertiary rehabilitation treatment of chronic work-related musculoskeletal injuries were evaluated with a comprehensive biopsychosocial assessment protocol at pretreatment and posttreatment. Moreover, at 1 year after completing the program, a structural telephone interview was conducted that assessed health and socioeconomic outcomes. Results: For the 1-year socioeconomic outcomes (such as posttreatment injury), the RI patients responded to rehabilitation at a level equivalent to the NRI patients. Demographic analyses revealed that RI patients, relative to NRI patients, were older, more represented by the dominant culture, had more education, had a shorter length of disability, had less severe types of injuries, had a greater rate of non-work-related health conditions, received higher disability payments, and had slightly greater job demand. The RI group also had a greater rate of pre-injury Axis I psychiatric disorders, particularly substance abuse/dependence disorders, than the NRI group. In addition, the RI group had greater job stability than the NRI group.

KW - Chronic pain

KW - Chronic spinal disorders

KW - Claims

KW - Compensation injuries

KW - Functional restoration

KW - Outcomes

KW - Recurrent injury

KW - Tertiary rehabilitation

KW - Workers' compensation

UR - http://www.scopus.com/inward/record.url?scp=0035343124&partnerID=8YFLogxK

U2 - 10.1016/S1529-9430(01)00079-1

DO - 10.1016/S1529-9430(01)00079-1

M3 - Article

C2 - 14588346

AN - SCOPUS:0035343124

VL - 1

SP - 183

EP - 189

JO - Spine Journal

JF - Spine Journal

SN - 1529-9430

IS - 3

ER -