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Journal of Occupational & Environmental Medicine:
doi: 10.1097/JOM.0b013e31820f3863
Original Articles

Health Maintenance Care in Work-Related Low Back Pain and Its Association With Disability Recurrence

Cifuentes, Manuel MD, PhD; Willetts, Joanna MS; Wasiak, Radoslaw PhD, MA, MSc

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Abstract

Objectives: To compare occurrence of repeated disability episodes across types of health care providers who treat claimants with new episodes of work-related low back pain (LBP).

Method: A total of 894 cases followed 1 year using workers’ compensation claims data. Provider types were defined for the initial episode of disability and subsequent episode of health maintenance care.

Results: Controlling for demographics and severity, the hazard ratio [HR] of disability recurrence for patients of physical therapists (HR = 2.0; 95% confidence interval [CI] = 1.0 to 3.9) or physicians (HR = 1.6; 95% CI = 0.9 to 6.2) was higher than that of chiropractor (referent, HR = 1.0), which was similar to that of the patients non-treated after return to work (HR = 1.2; 95% CI = 0.4 to 3.8).

Conclusions: In work-related nonspecific LBP, the use of health maintenance care provided by physical therapist or physician services was associated with a higher disability recurrence than in chiropractic services or no treatment.

©2011The American College of Occupational and Environmental Medicine

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