Researchers show personal factors play major role in deciding duration of sick leave

Patients, sick-listed for back and neck problems return to work at different rates despite having similar problems, and personal factors play a major role, reveals a thesis from the University of Gothenburg, Sweden.

Researchers followed 385 patients in a rehabilitation programme over a ten-year period. The participants were sick-listed as a result of back and neck problems and were asked to self-rate their pain, functional ability and quality of life. Fitness levels were tested and the length of sick leave registered. The patients were also asked about their feelings and thoughts of their future working life.

The results showed, among other things, that the participants who had the motivation and drive to work returned to their jobs more quickly than those who were uncertain and had doubts about their work situation. Patients' ability to handle and understand the situation is also important if they are to cope with working life again.

"Patients who lack motivation or who have a poor quality of life should perhaps have some form of counselling instead of physiotherapy," says Marie Lydell, registered physiotherapist and researcher at the Department of Public Health and Community Medicine. "At the same time, other resources should be allocated to those with good potential to get back to work. In such cases, it might be enough for a physiotherapist to act as a coach rather than give traditional treatment."

She feels that the healthcare system needs better tools to predict which patients will go back to work quickly and which patients will take longer to return.
"It would mean that we could offer the best possible rehabilitation to every patient," says Lydell. "A reducing of every patient's suffering is the biggest gain, but there are also major economic benefits."

Back Problems
Back and neck problems are among the most common causes of sick leave in Sweden. As many as one in five Swedes is thought to suffer from back pain at some point each year, and although it generally goes away, it is a long-term problem for around 200,000 people. In 80 per cent of these cases the pain cannot be attributed to a specific injury or illness. Where the pain can be traced to specific causes, they are usually slipped discs, stenosis or osteoporotic fractures, and occasionally other conditions.