First return to work after injury doesn't always mean full recovery

In brief

  • Pain, depressive symptoms and work limitations continued for many workers with MSDs even after they returned to work, confirming that a first return to work is not a sign of complete recovery.
  • Still, the health of injured workers was connected with return-to-work status. Those who didn't have repeated work absences reported better health overall.

Why was this study done?

This study looked at the mental and physical health of injured workers at different points in their return-to-work (RTW) process. Recovery from soft-tissue or musculoskeletal disorders (MSDs) is complex. The RTW process can be equally complex, punctuated by repeated work absences. Many studies have focused on a worker's first return to work as the key sign of successful RTW, but workers may not be fully recovered at this stage.

How was the study done?

Researchers interviewed 632 workers with lost-time claims at the Ontario Workplace Safety and Insurance Board. These workers had work-related MSDs of the back or upper body. They were asked to provide information about their physical and mental health, as well as about their workplaces, health-care providers and insurers. The first interview took place one month after the injury and the second was six months after injury.

What did the researchers find?

Researchers identified three return-to-work categories one month after injury:

  1. Sustained first return to work, meaning workers remained on the job after returning (reported by 47 per cent of workers)
  2. Return to work with recurrent work absences (reported by 16 per cent)
  3. No return to work (reported by 37 per cent).

Many workers in all categories reported poor health, work limitations and symptoms of depression one month after injury. However, those with a sustained first RTW reported better physical and mental health and fewer limitations overall. At the six-month follow-up, 38 per cent of all workers who had attempted a return to work reported at least one absence from work. This happened even in 27 per cent of workers who reported a sustained return to work at the first interview.

What are some strengths and weaknesses of the study?

Study participants appeared to have similar workplace characteristics as all injured workers with MSDs. However, compared to all injured workers with MSDs, workers in our study tended to be older and female. They had also received benefits for a longer time period. As a result, reports of work absences may be higher than the general population of injured workers with MSDs.

Publication Information

Title: 

Health status, work limitations, and return-to-work trajectories in injured workers with musculoskeletal disorders

Author(s): 

Bultmann U, Franche R-L, Hogg-Johnson S, Côté P, Lee H, Severin C, Vidmar M, Carnide N

Journal: 

Quality of Life Research, 2007: vol. 16, no. 7, pp. 1167-1178