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Abstract
Patients with back pain taking few (< 14) or many (> 180) days sick leave during the 12 months following a 5 week physiotherapy intervention were compared. The factors found to co-vary with long sick leave were a restricted education, sleep disturbances, an experience of severe pain, immigrant status and the taking of sick leave prior to the physiotherapy intervention. The 36 patients who took many days of sick leave after the physiotherapy intervention (mean = 274.3 days) were found to have taken on average 95 days of sick leave prior to the intervention, whereas the 50 patients who took only a few days of sick leave after the intervention (mean = 6.9 days) were found on average to have taken only 43.1 days of sick leave prior to the intervention. The increase seen in the former group and the decrease seen in the latter group were both significant (P<0.0001). Patients who have already taken long periods of sick leave may view themselves as ‘pain patients’, a feeling that may be reinforced by conventional physiotherapy. The cognitive and behavioural aspects of pain management therefore need to be taken into account by therapists.