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Long-Term Results for Worker's Compensation Patients with Low Back Pain

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Long-Term Results for Worker's Compensation Patients with Low Back Pain

In this study, patients with sciatica due to disc herniation were observed over a 10-year period of time. The goal of the study was to compare long-term outcomes between workers who received worker's compensation (WC) and those who didn't.

Health-related quality of life was also measured. The authors looked for ways to predict the final results for patients receiving WC. Some of the patients were treated with surgery to remove the disc. Others had a wide range of nonsurgical treatment.

Work status and disability status were measured by survey (questionnaires mailed to the participants). Subjects completed the same survery every year for 10 years. Questions were asked to see if the person was working or receiving any compensation for back problems or sciatica. Everyone was asked if they had hired a lawyer because of their current back problems.

Other information was collected about pain, symptoms, function, and quality of life. All data was analyzed to find factors present from the beginning that were linked with better results in the end for patients getting WC.

The following results were reported:

  • Workers getting WC were young, male, less well educated, and smoked
  • WC workers were less likely to have surgery and more likely to have a lawyer
  • Those on WC were less likely to have been working when they enrolled in this study
  • WC patients were more likely to have physically demanding jobs
  • Back pain but not leg pain was worse in WC workers compared to similar workers who were not on WC
  • Five to 10 years later, most workers were no longer on WC; they were not disabled and they were working

    The authors conclude that the majority of disability costs come from a small number of people. Physicians should treat the patient's condition knowing that most people will get back to work and won't be permanently disabled. Surgery should not be withheld from fear that the outcome is negative in WC patients.

    Steven J. Atlas, MD, MPH, et al. The Impact of Disability Compensation on Long-Term Treatment Outcomes of Patients with Sciatica Due to a Lumbar Disc Herniation. In Spine. December 15, 2006. Vol. 31. No. 26. Pp. 3061-3069.

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