RTW Knowledge Base
RTW Knowledge Base
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The issue for treaters

Long-term sick leave is associated with a decrease in physical, mental and social health.
Improving return to work outcomes, the Knowledge Base, and the world wide movement to reduce work disability

After sick leave, most people return to work quickly and do well.
How to use the site

The site has been organized so article viewing can be done in a number of ways.
Research in work disability

Evidence-based medicine is a worldwide movement to help understand effective prevention, treatment and management approaches in health.
Medical Factors
Treatment Approaches and RTW
Healthcare Provider participation is important in achieving early return to work

When health care professionals communicate with both the patient and their workplace an injured worker's likelihood of returning to work improves.
Family physicians' experiences with workplace injuries

Worker's compensation authorities could benefit from a better understanding of general practice and the barriers to cooperation between doctors, employers and insurers.
Improving communication between treating practitioners results in an earlier return to work

Improving communication between treating health-professionals improves patient return to work.
People who receive financial compensation are less likely to recover well after surgery

People who receive financial compensation for their condition are less likely to recover well after surgery.
Chronic pain can be a struggle for everyone

Chronic pain is a difficult problem for patients and doctors.
How patients communicate their illness

Patient communication may play a significant role in health care.
The role and obstacles faced by family GP's assisting patients to return to work

Quality information, rather than assumptions, is fundamental to return to work
Move it or lose it, underuse as a cause of injuries to muscles and bones

Underuse may contribute to musculoskeletal problems
Key messages and advice about rehabilitation from lumbar surgery

An information booklet, providing clear, evidence-based information, can help patients after spine surgery.
The effects of a specialist healthcare provider network for workplace injuries on costs and lost time

Directing injured employees to a health care network can reduce their medical costs and time off work.
Stress Management and Workplace Disability.

Stress-management is a cost-effective way to improve recovery after injury or illness.
Preventing occupational stress

Occupational stress can be prevented. Interventions aimed at the individual or at the workplace can effectively reduce stress, burnout and physical illness and reduce the costs of work absence and turnover.
Occupational wellbeing and its effect on performance

Improving wellbeing improves productivity.
Current trends in stress claims.

Stress-related compensation claims are a costly problem. This review investigates the role of compensation in recovery and factors that influence return to work.
Low back pain - how long does it last? The normal course of pain experienced by people who visit their general practitioner

Patients with back problems are often told by general practitioners that they should get better within a matter of weeks.
Low back pain - what do patients think about it? What do they need from their doctor?

Back pain is a common condition. Patients are looking for a better understanding about the condition.
Spinal imaging - is it a help or a hindrance?

There is a poor correlation between scan findings and the severity of back problems.
Low back pain - how common is it and how often does it cause disability?

How common are back problems? Back pain is experienced by the majority of people at some point in their lives.
Spinal radiographic findings and nonspecific low back pain: A systematic review of observational studies

X-ray findings are not a good indicator of whether a person is likely to experience back pain.
Why do Spinal Surgeons who have spine surgery get back to work quickly?

Spinal surgeons who have surgery on their own backs return to work quickly.
People who get clear advice about their back problem do much better.

People with back pain increase their chance of recovery and return to work when they remain active, stretch back muscles, and return to everyday activity.
Are treating practitioners overly cautious with people with back pain?

General practitioner and physical therapists' beliefs about back pain influence their treatment practice.
Will an episode of low back pain become a long-term problem? Our psychology is important in deciding.

Psychological factors like distress levels and depressive mood influence whether or not an episode of back pain will be the beginning of a long term problem.
Patients whose treaters explain their subacute low back pain condition in detail have better outcomes

Simple clear information about back pain early on in the condition can help reduce patients' daily symptoms and sick leave in the future.
Good explanation of the condition by the treater results in patient satisfaction with treatment of acute low back pain.

Patients with back pain regard good communication from their doctor very highly.
The impact of Back Schools on return to work

After an episode of back pain, education, training and exercise programs can help people to return to work.
Preventing low back pain

European guidelines for preventing the negative consequences of low back pain
Risk factors for work related low back pain and strategies to prevent long term disability

Risk factors for work-related low back pain that leads to long term disability.
Strength training as treatment for chronic neck pain

Physical training to improve strength or endurance can reduce pain and disability in work-related neck pain.
To stretch or to strengthen? Exercises for whiplash, neck pain and neck pain that involves headaches.

Including neck exercises in the treatment of neck pain reduces pain and improves function.
Manual therapies including manipulation may help acute neck pain.

Acute neck pain usually gets better without treatment. Manual therapies such as manipulation may reduce pain and increase range of motion.
The gold-standard treatment for whiplash

This article describes the most effective treatments for whiplash based on 23 scientific trials.
Upper Limb (arm)
What helps people with long-term arm pain return to work?

Whether a person with long-term arm pain will return to work depends on their specific beliefs and experiences of working with pain.
Integrated case management for work-related arm pain

A co-ordinated approach to managing work-related arm pain improves return to work, and results in higher levels of patient satisfaction.
Return to work after carpal tunnel surgery

Patients are likely to have better function after carpal tunnel surgery if they work in a supportive environment and are confident they can manage their symptoms.
Stress and work-related hand and arm injuries - implications for prevention and management

Reducing stress might reduce work-related hand and arm injuries.
Repetitive strain injury

Repetitive work can cause non-specific arm pain, but there are other factors involved.
Ergonomic and psychosocial factors affect function in workers with upper extremity disorders.

Management of non specific arm pain is helped by improving problem solving skills and workplace ergonomics.
Factors behind work related neck and upper limb problems: Psychosocial and personal risk factors, and effective interventions from a bio behavioural perspective.

Work-related psychological and social factors can put people at risk of neck and upper limb conditions.
Consequences of being off work
Use it or lose it - No really!

The Disuse Syndrome. Being physically inactive can kill you.
Unemployment and mental health: Understanding the interactions among gender and family roles

The effects of being out of work and resulting health complications are different for men and women and vary with their roles in family life.
The health effects of being out of work

Being out of work increases your risk of getting sick or dying
The effect of financial compensation on rehabilitation

Those who receive compensation payments after an injury are less likely to return to work.
Unemployment can affect your children's health

Long-term unemployment of parents can affect the health of their children, even if money is not scarce.
Workplace Factors
Workplace Interventions
Work is therapeutic - rehabilitation at work

Rehabilitation programs are more effective when they acknowledge the therapeutic nature of work, and provide modified duties to employees who are returning to work.
A workplace education program that prevents neck and back problems, and limits reinjury

Teaching workers to minimise strain at work, change posture and exercise regularly had a long-lasting positive effect on workers with back and neck injuries.
Flexibility in the workplace assists people on long-term sickness absence to return to work

Flexibility at the workplace helps improve return to work outcomes
People Factors
Factors influencing RTW
Understanding the person's state of mind helps you help them

Understanding how people view their pain and their work environment is needed so that these important factors can be addressed.
Does problem-solving therapy reduce work-related disability from nonspecific low back pain?

Teaching workers general problem-solving skills, in combination with other treatments, helps prevent disability from back pain.
Different influences combine to affect whether a person will return to work after sick leave

Many factors influence whether a person on sick leave will return to work.
Community based psychosocial intervention for musculoskeletal disorders

Understanding the psychological factors of pain are important for a return to work.
Tools for creating goals with patients as a part of therapy

Focusing on what the patient wants to get out of therapy improves results.
Practical advice for GPs: treating patients with workplace injuries

Good morale helps employees recover and return to work after injury.
Does multidisciplinary rehabilitation work? How does patient motivation affect outcomes?

Rehabilitation programs are often provided for musculoskeletal conditions. When these programs treat the 'whole person' rather than focusing purely on medical problems, they are more cost effective. The best results are produced when patients are highly motivated.
Beliefs and attitudes and RTW
Factors that can affect a person's ability to return to work

An in-depth look at some of the issues that can influence return to function and work
Does screening work? Psychosocial risk factors for work absence due to sprains and strains

Questionnaires can identify employees who are more likely to take time off work, but not those at risk of disability, or long term absence from work.
The impact of expectations on return to work

Beliefs and expectations about returning to work can affect the outcome for people with low back pain.
Fear of pain is likely to slow recovery

If people think that any pain means their condition is being aggravated, they sometimes avoid their normal activities. This can slow their recovery.
Does how you recover depend on how you think you'll recover?

A person's expectations about recovery have an impact on what happens.
'Self-efficacy' is your ability to confidently manage your health condition and return to normal activities, including work

Those who feel capable of achieving a positive return to work outcome are more likely to make it.
People on compensation experience more pain, but not because of economic gain

Traumatic injuries and compensation: two issues that effect a patien's experience of chronic pain.
Building confidence: the first step in successful rehabilitation

Rehabilitation is most successful when it first improves patients' confidence.
Predicting delayed RTW
Knowing the return to work expectation of an injured worker is an important first step

The predictions of injured workers regarding returning to work are 98% accurate.
The Worker Role Interview - understanding the person

A person's ability to work is affected by many things. Understanding what is influencing the person can help return to work management.
Factors that influence the duration of sick leave due to low-back pain

A short questionnaire in the first few days of sick leave can help to identify workers at risk of long-term sick leave due to back pain.
RTW Approaches and Interventions
Elements of effective schemes
Common ingredients of successful rehabilitation programs

Rehabilitation programs are more likely to be effective when they provide participants with education, physical and psychological treatment, worksite modification and training in good work practices.
Motivational interviewing empowers patients

Motivational interviewing plays a key role in reviewing, analysing and providing knowledge during consultation.
Workplace based early intervention programs get people back to work sooner

A well designed, correctly implemented workplace program can reduce sickness absence.
A simple proven return to work model

Early simple management of medical conditions improves return to work outcomes
The importance of goal-setting in rehabilitation

Goal setting is a powerful way to aid the rehabilitation process.
Return to work communication

There are different models for managing the return to work, but similar problems affect most programs. Improving communication can improve return to work outcomes.
Halve the length of sickness absence and double the rate of return to work

Modified work programs help people return to work after illness or injury.
System factors
Injury recovery may be affected by compensation

When a person is compensated for their injury they may not achieve a desirable recovery outcome.