Patients with low back pain. Psychosocial work-related factors and return to work - a literature review

Background. Since the 19905 work-related rehabilitation programs have gained more importance in orthopaedic rehabilitation. Although inception cohort studies of patients with low back pain have indicated the prognostic relevance of psychosocial work-related factors for return to work, these factors and the interaction of these factors with restrictions in functional capacity have been less extensively considered during the rehabilitation process so far. Methods. Systematic reviews on the course of low back pain were reviewed concerning the prognostic relevance of psychosocial work-related factors for return to work. Results. Seven reviews were comparable concerning the outcome analysed (return to work) and the populations considered (acute/subacute). These reviews confirmed that patients with low back pain and low social support from supervisors and colleagues, low decision latitude, high psychosocial work demands and a poor subjective prognosis have a lower chance of returning to work. The prognostic relevance of job satisfaction was contradictory. Conclusion. Rehabilitation should be aimed at supporting and developing strategies for coping with psychosocial work stress.