Expectations predict recovery in employees with back pain but not other bone and joint conditions

31 January 2011

(Edmonton) Can back pain be a self-fulfilling prophecy? Quite possibly.

A recent University of Alberta study by Doug Gross and Michele Crites-Battié, researchers from the Faculty of Rehabilitation Medicine, has found that when an employee is suffering from back pain, the more they perceive their pain as chronic, the slower their recovery time.

The two looked at 1,040 workers' compensation claims and discovered that employees experiencing a work-related back injury were likely to have negative expectations of their rate of recovery and return-to-work time. This expectation seemed to have a bearing on their recovery time. The study was recently published in the Journal of Spinal Disorders & Techniques.

"Back pain is generally perceived to be a chronic condition, so workers often don't think they will ever get better, and we found that this expectation correlates with actual recovery," said Gross. The study also found this correlation is not present in workers with more specific conditions such as a fracture or joint dislocation.

The sample claimants each filled out a work-related recovery expectations survey: 29 per cent had back conditions; 44 per cent had sprains, strains or pain of other body parts besides the back; 23 per cent had specific injuries such as fracture, dislocation or amputation; and five per cent had other compensable conditions such as carpal tunnel syndrome. Fifty-eight per cent of claimants with back pain reported negative expectations, a higher percentage compared to the other groups, which were all within 47 per cent to 51 per cent.

"We analyzed workers' scores on a work-related recovery expectations questionnaire and found that employees with negative expectations about their back pain were about 20 per cent less likely to return to work over the next year," said Crites-Battié.

What does this mean for employees and employers? "Back pain doesn't have to be chronic and people can recover. In fact, most back pain recovers quickly if people stay positive and keep up regular activities as much as possible.," Gross said. "Workplace support from colleagues and company leadership is also very important. Co-workers and employers can help injured workers maintain optimistic expectations about return-to-work. A positive and collaborative approach between workers, employers, health-care providers and other stakeholders can go a long way towards helping workers recover from back problems."

About the University of Alberta Faculty of Rehabilitation Medicine
As the only free standing faculty of rehabilitation in Canada, the University of Alberta Faculty of Rehabilitation Medicine balances its activities among learning, discovery and citizenship (including clinical practice). A research leader in musculoskeletal health, spinal cord injuries and common spinal disorders (back pain), the Faculty of Rehabilitation Medicine aims to improve the quality of life of citizens in our community. The three departments, Occupational Therapy (OT), Physical Therapy (PT) and Speech Pathology and Audiology (SPA) offer professional entry programs. The Faculty offers thesis-based MSc and PhD programs in Rehabilitation Science, attracting students from a variety of disciplines including OT, PT, SLP, psychology, physical education, medicine and engineering.