Health Maintenance Care in Work-Related Low Back Pain and Its Association With Disability Recurrence
Health Maintenance Care in Work-Related Low Back Pain
and Its Association With Disability Recurrence
SOURCE: J Occupat Enviro Med 2011 (Apr); 53 (4): 396–404
Manuel Cifuentes, MD, PhD,
Joanna Willetts, MS, and
Radoslaw Wasiak, PhD, MA, MSc
Center for Disability Research
Liberty Mutual Research Institute for Safety
University of Massachusetts Lowell
This study is unique in that it was conducted by the Center for Disability Research at the Liberty Mutual Research Institute for Safety AND the University of Massachusetts Lowell, Hopkinton, Mass
Their objective was to compare the occurrences of repeated disability episodes between types of health care providers, who treat claimants with new episodes of work-related low back pain (LBP). They followed 894 patients over 1-year, using workers’ compensation claims data.
By controlling for demographics and severity, they determined the hazard ratio (HR) for disability recurrence between 3 types of providers:
The results are quite interesting:
Statistically, this means you are twice as likely to end up disabled if you got your care from a Physical Therapists (PT), rather than from a chiropractor.
You’re also 60% more likely to be disabled if you choose a Physicians (MD) to manage your care, rather than a chiropractor.
The authors concluded:
OBJECTIVES: To compare occurrence of repeated disability episodes across types of health care providers who treat claimants with new episodes of work-related low back pain (LBP).
METHOD: A total of 894 cases followed 1 year using workers’ compensation claims data. Provider types were defined for the initial episode of disability and subsequent episode of health maintenance care.
RESULTS: Controlling for demographics and severity, the hazard ratio [HR] of disability recurrence for patients of physical therapists (HR = 2.0; 95% confidence interval [CI] = 1.0 to 3.9) or physicians (HR = 1.6; 95% CI = 0.9 to 6.2) was higher than that of chiropractor (referent, HR = 1.0), which was similar to that of the patients non-treated after return to work (HR = 1.2; 95% CI = 0.4 to 3.8).
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