Work-Related Chronic Low Back Pain—Return-to-Work Outcomes After Referral to Interventional Pain and Spine Clinics

In Brief Study Design. A retrospective cohort study. Objective. To evaluate return-to-work outcomes in patients with chronic, work-related low back pain referred to pain treatment centers and/or spine clinics (PTCs/SCs). Summary of Background Data. Return-to-work outcomes in cases of work-related chronic low back pain after referral to PTCs and/or SCs have not been previously studied. Methods. A retrospective chart review of 230 consecutive patients was conducted from an occupational medicine program. Of these, 122 patients were referred to a PTC/SC and 108 patients were not. Multivariate logistic regression was used to develop a model to predict improvement in functional status and pain level after 1 year. Results. At the 1-year evaluation, there was functional improvement in the nonreferral group (P < 0.001) and no change in the referral group (P = 0.21). The change in pain level was similar. Time from injury to initial evaluation seemed to be the major factor contributing to poor outcomes in both groups. Conclusion. Referral to a PTC/SC did not yield improved functional outcomes in this cohort. A major factor contributing to this finding was the length of time to referral to PTC/SC after the initial injury. Patients with chronic occupational low back pain not referred to pain treatment centers/spine clinics had better functional outcomes than referred patients. A major factor contributing to this was the time since injury. The current referral patterns to these centers do not result in improved functional outcomes.