The association between compensation and chronic disabling back pain.

BACKGROUND

Low back pain (LBP) is a common and major health problem. Although it is known that psychosocial factors are important predictors of LBP outcome, some factors, including financial compensation, have not been fully studied in Japan. This cross-sectional study aimed to examine the association between LBP compensation (workers' compensation and automobile insurance claims) and lifetime experience of chronic LBP and back pain disability (chronic disabling LBP) in a Japanese adult population.

METHODS

In February 2011, 1,063,083 adults aged 20-79 years registered as Internet research volunteers were invited to complete an online questionnaire. We analyzed the data from 52,650 respondents who had ever experienced LBP. Multiple logistic regression analysis was used to examine the association between LBP compensation and lifetime experience of chronic disabling LBP, adjusting for age, sex, smoking habits, educational level, cause of LBP, history of radiating pain below the knee, and history of low back surgery.

RESULTS

Among the respondents, 2,039 (3.9 %) had experienced chronic disabling LBP. The prevalence of a history of receiving workers' compensation or automobile insurance claims was 1.1 % for each. In multiple logistic regression, the odds of chronic disabling LBP were significantly higher among those who received LBP-related compensation (workers' compensation or automobile insurance claims) compared with respondents who did not receive compensation.

CONCLUSIONS

The prevalence of compensated LBP was low. However, a history of compensated LBP was significantly associated with experiencing chronic disabling LBP.