Early prognosis for low back disability: intervention strategies for health care providers

Findings from available studies of prognostic factors for OLBP disability in a clinically-relevant framework are synthesized to evaluate interventions guided by prognosis and develop clinical recommendations based on the evidence.

Abstract

Of 361 studies of OLBP disability found, 22 met specific criteria for inclusion. Significant prognostic factors included low workplace support, personal stress, shorter job tenure, prior episodes, heavier occupations with no modified duty, delayed reporting, severity of pain and functional impact, radicular findings and extreme symptom report. Physicians can decrease OLBP disability by using standardized questionnaires, improving communication with patients and employers, specifying return to work accommodations, and employing behavioural approaches to pain and disability management. Future studies should evaluate interventions guided by prognosis.