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Meta-Analysis
. 2014 Jun;71(6):448-56.
doi: 10.1136/oemed-2013-101571. Epub 2013 Nov 1.

Absence from work and return to work in people with back pain: a systematic review and meta-analysis

Gwenllian Wynne-Jones  1 , Jemma Cowen, Joanne L Jordan, Olalekan Uthman, Chris J Main, Nick Glozier, Danielle van der Windt
Affiliations
Free PMC article
Meta-Analysis

Absence from work and return to work in people with back pain: a systematic review and meta-analysis

Gwenllian Wynne-Jones et al. Occup Environ Med. 2014 Jun.
Free PMC article

Abstract

Background: A considerable proportion of work absence is attributed to back pain, however prospective studies in working populations with back pain are variable in setting and design, and a quantitative summary of current evidence is lacking.

Objective: To investigate the extent to which differences in setting, country, sampling procedures and methods for data collection are responsible for variation in estimates of work absence and return to work.

Methods: Systematic searches of seven bibliographic databases. Inclusion criteria were: adults in paid employment, with back pain, work absence or return to work during follow-up had been reported. Random effects meta-analysis and meta-regression analysis was carried out to provide summary estimates of work absence and return to work rates.

Results: 45 studies were identified for inclusion in the review; 34 were included in the meta-analysis. The pooled estimate for the occurrence of work absence in workers with back pain was 15.5% (95% CI 9.8% to 23.6%, n=17 studies, I(2) 98.1%) in studies with follow-up periods of ≤6 months. The pooled estimate for the proportion of people with back pain returning to work was 68.2% (95% CI 54.8% to 79.1%, n=13, I(2) 99.2%), 85.6% (95% CI 78.2% to 90.7%, n=13, I(2) 98.7%) and 93.3% (95% CI 84.0% to 94.7%, n=10, I(2) 99%), at 1 month, 1-6 months and ≥6 months, respectively. Differences in setting, risk of participation bias and method of assessing work absence explained some of the heterogeneity.

Conclusions: Pooled estimates suggest high return to work rates, with wide variation in estimates of return to work only partly explained by a priori defined study-level variables. The estimated 32% not back at work at 1 month are at a crucial point for intervention to prevent long term work absence.

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Figures

Figure 1
Figure 1
Flow diagram showing the results of the search and selection of papers.
Figure 2
Figure 2
Summary of results regarding occurrence (%) of work absence in back pain populations based on studies with at least 6 months’ follow-up.
Figure 3
Figure 3
Summary of results regarding return to work following back pain related work absence (%).
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