FEATURE experience a greater risk of depression, sleep problems and medication abuse than the general population. They may also be at greater risk of early mortality. It’s important for chiropractors to understand the factors that affect the length of time it takes before low-back pain patients return to work. In a past IWH focus group study, many chiro-practors said their role includes provid-ing education, reassurance and encour-agement to patients to remain active, in addition to using manipulation to con-trol pain. “We are primary care providers, and injured workers with low-back pain will sometimes seek out our care before they go to their family physicians,” says Dr. Peter S. Y. Kim, a fellow of the College of Chiropractic Sciences and an associ-ate professor at the Canadian Memorial Chiropractic College. He is also a mem-ber of IWH’s Educationally Influential Chiropractor Network. “As a result, chiropractors have a responsibility to use the up-to-date information that’s available to them to help manage the condition before it becomes chronic.” As chiropractors treat injured workers with low-back pain, they are sometimes asked about prognosis for recovery and expected amount of time before the workers can return to full work. Re-search conducted at the IWH has pro-duced a systematic review that may help practitioners make the determination. According to the systematic review, led by Dr. Ivan Steenstra, then associate scientist at the Institute, strong evidence suggested these following factors influ-ence return to work among those with acute low-back pain: • recovery expectations; • workers’ interactions with health-care providers (i.e., type of health-care provider seen and nature of care received); • workers’ self-reported pain and functional limitations; • presence of radiating pain (an indi-cation of the severity of the injury); and • work-related factors, which include physical demands of the job, job satisfaction and the offer of modi-fied work. www.canadianchiropractor.ca WORKERS’ COMPENSATION Early intervention WHAT THE EVIDENCE SAYS L Evidence-based predictors of return-to-work in work-related LBP patients BY UYEN VU absences result in workplace disrup-tions and productivity losses to em-ployers, and high compensation and treatment costs to workers’ compensa-tion and public health systems. More importantly, lengthy delays also have detrimental consequences for the injured worker. According to re-search conducted by the Institute for Work & Health (IWH) or with IWH involvement, depressive symptoms are more common among workers who are not back at work at 12 months. Workers permanently impaired by a job injury ow-back pain is a leading cause of work absenteeism in Canada and other industri-alized countries. Most work-ers with acute low-back pain (those experiencing pain for up to six weeks) return to work following a relatively straightfor-ward path. Unfortunately, some do not. Studies show that anywhere between one in five to one in three workers with acute low-back pain develop chronic pain (defined as pain lasting longer than three months). Lengthy disability UYEN VU is communications associate and editor of the Institute for Work & Health’s quarterly newsletter, At Work . The Institute for Work & Health is a not-for-profit, independent research organization focusing on work-related injury and disability prevention. 24 Canadian Chiropractor June 2016 Photo: Fotolia
Chiropractic + Naturopathic Doctor June 2016: Page 24
