ABSTRACTObjectivesTo describe incidence, duration, and patterns of working time loss claims in compensated Australian workers with low back pain (LBP), and compare this with other musculoskeletal conditions.MethodsThe National Dataset for Compensation-based Statistics (NDS) was used for this study. Any accepted workers’ compensation time loss claims for LBP, limb fracture or limb soft tissue disease occurring between July 2010 and June 2015 were included. Demographic information, occupation, and total cumulative time loss data were extracted. Counts, rates per 10,000 covered workers, the relative risk and median duration of time loss were calculated. Multivariate Cox and quantile regression models were used to determine factors affecting time loss duration and patterns.ResultsThere were 56,102 LBP claims, 42,957 limb fracture claims, and 18,249 limb soft tissue disease claims. The relative risk of a claim for LBP was significantly greater than limb fractures after adjustment for all covariates (RR 1.30, 95%CI 1.29 – 1.32, p < 0.001). LBP claims had longer median time loss (9.39 weeks) than limb fracture claims (9.21 weeks). Quantile regression demonstrated that LBP claims were more likely than limb fracture claims to resolve within seven weeks, and to persist for periods beyond seven weeks.ConclusionsThere were differential patterns of time loss in LBP claims and limb fracture claims. The interaction between conditions, and policies and practices may contribute to these patterns. The findings should reiterate to workers’ compensation stakeholders the importance of returning a worker to work as soon as practicable, to avoid future delays or challenges.KEY MESSAGESWhat is already known about this subject?LBP is a prevalent musculoskeletal symptom the leading contributor to the burden of disability for people of working age.Musculoskeletal conditions like LBP comprise the largest proportion of compensated conditions in Australia.What are the new findings?The incidence of claims for work-related LBP is higher than other work-related musculoskeletal conditions.Median time loss associated with a claim for LBP is similar to time loss for a claim for a limb fracture but less than for limb soft tissue disease claims.The likelihood of time loss duration is greater for workers with claims LBP than claims for limb fracture in the short term (seven weeks), but lower than limb fracture claims after this time.How might this impact on policy or clinical practice in the foreseeable future?Workers’ compensation stakeholders including clinicians, insurers, and workers’ compensation authorities should carefully consider the importance of returning a worker to work as soon as practicable to avoid future challenges, particularly for a condition as burdensome as LBP.
Is It Time to Consider Soft Tissue as a Pain Generator in Nonspecific Low Back Pain?