Many theories have been proposed about whether we can predict if a patient who presents with an acute low back injury will develop chronic low back pain (LBP).
This information is vital with regards to workplace injuries, as we all know musculoskeletal lower back injuries sustained at work have a high likelihood of becoming long-term, costly claims. And with many workers experiencing back pain with the new COVID-impacted working arrangements, it’s worthwhile to explore whether we can predict the likelihood of these injuries becoming long-term Workers’ Compensation claims.
Emma Karran from the Body in Mind Research Group at the University of South Australia recently completed a systematic review of the commonly used tools (self-reporting questionnaires) available to predict the likelihood of a patient developing chronic LBP and disability. She drew the following conclusions:
- “The tools seem to differentiate patients with poor disability outcomes and prolonged absenteeism from those who recover”
- “The tools are consistently poor at differentiating who will and will not develop persistent pain”
- “Using these tools for prognostic screening can inform us most accurately about work-related outcomes”
Whilst these findings are interesting, they prompt a few new questions (as all good research should):
- What are the differences between results from work and non-work related injuries? (…we all hate to assume, but I know what we’re all thinking!)
- If the tools predict that a worker will “recover” from a return-to-work perspective, however, fail to identify the likelihood of persistent pain, will this lead to an increased likelihood of future injury aggravation and claims?
The primary tools involved in the study included the STarT Back Tool, Orebro Musculoskeletal Pain Screening Questionnaire, and the Vermont Disability Prediction Questionnaire. These are all commonly used in the Workers’ Compensation system with varying levels of emphasis. I think the take-home message from this research is that we need to remember that these tools are a guide for patient management, not a rule to determine claims duration.
PS: Search ‘Preventure.Live’ on the Google Play or Apple app store to download our free injury prevention app and learn more about Preventure.
Source: Karran EL, McAuley JH, Traeger AC, Hillier SL, Grabherr L, Russek LN, Moseley GL: Can screening instruments accurately determine poor outcome risk in adults with recent onset low back pain? A systematic review and meta-analysis. BMC Medicine 2017, 15(1):13