• J. Occup. Environ. Med. · Feb 2007

    Patient clusters in acute, work-related back pain based on patterns of disability risk factors.

    • William S Shaw, Glenn Pransky, William Patterson, Steven J Linton, and Thomas Winters.
    • Liberty Mutual Research Institute for Safety, Center for Disability Research, Hopkinton, Massachusetts 01748, USA. william.shaw@libertymutual.com
    • J. Occup. Environ. Med. 2007 Feb 1;49(2):185-93.

    ObjectiveTo identify subgroups of patients with work-related back pain based on disability risk factors.MethodsPatients with work-related back pain (N = 528) completed a 16-item questionnaire of potential disability risk factors before their initial medical evaluation. Outcomes of pain, functional limitation, and work disability were assessed 1 and 3 months later.ResultsA K-Means cluster analysis of 5 disability risk factors (pain, depressed mood, fear avoidant beliefs, work inflexibility, and poor expectations for recovery) resulted in 4 sub-groups: low risk (n = 182); emotional distress (n = 103); severe pain/fear avoidant (n = 102); and concerns about job accommodation (n = 141). Pain and disability outcomes at follow-up were superior in the low-risk group and poorest in the severe pain/fear avoidant group.ConclusionsPatients with acute back pain can be discriminated into subgroups depending on whether disability is related to pain beliefs, emotional distress, or workplace concerns.

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