Return to Work after Musculoskeletal Injury

Getting patients back to work after on-the-job injuries is a major health issue in the U.S. According to the literature, most workers get back on the job without difficulty or disability. A small percentage of patients, however, do not recover quickly, and are responsible for the majority of expense. Predicting which patients are going to have difficulty is a common area of research, and is the focus of this current study from Canada.

In this study, the authors examined the records of 148 patients who had been off the job for over three months. The study found:

• Men were 1^1/2 times more likely to return to work than were women.
• The chance of a worker getting back on the job decreased 20% for every decade increase in age.
• Patients with functional disability and high levels of psychological distress were significantly less likely to return to work.
• The authors found that workers who were offered a "modified job" were twice as likely to return to work than were those patients not offered such flexibility. "Some of the ways the employer modified the job were through a change in the physical or cognitive demands, shorter hours, rest periods, modification of machinery, or a decrease in expected output."

The authors stress that getting the patient back to work requires "examining the interactive relationship between the worker, the workplace, the social situation of the worker, and the resources available to the worker in dealing with the consequences of impairment or disability."

Crook J, Moldofsky H, Shannon H. Determinants of disability after a work related musculoskeletal injury. Journal of Rheumatology 1998;25:1570-1577.