Journal of Occupational Rehabilitation

, Volume 16, Issue 3, pp 430–458 | Cite as

Prediction of Sickness Absence in Patients with Chronic Low Back Pain: A Systematic Review

  • Wietske KuijerEmail author
  • Johan W. Groothoff
  • Sandra Brouwer
  • Jan H. B. Geertzen
  • Pieter U. Dijkstra
Original Paper

Objectives: To provide evidence of predictors for sickness absence in patients with non-specific chronic low back pain (CLBP), distinguishing predictors aimed at the decision to report sick (absence threshold) and decision to return to work (return to work threshold). Methods: Medical and psychological databases were searched, as well as citations from relevant reviews. In- and exclusion criteria were applied. Two reviewers assessed the methodological quality of the papers independently. Results: Many different predictors were studied, and few factors were studied more than once. Consistent evidence was found for own expectations of recovery only as predictor for the decision to return to work. Patients with higher expectations had less sickness absence at the moment of follow-up measurement. As expected, different predictors were found aiming at the absence threshold or the return to work threshold. Furthermore, predictors varied also with the measurement instruments used, timing of follow-up measurements, and definition of outcomes. Until now, too few studies are available to overcome several potential sources of heterogeneity. Conclusions: No core set of predictors exists for sickness absence in general. The characteristics of the study including the decision to report sick or to return to work determined the influence of several predictors on sickness absence in patients with CLBP. Further research and use of a core set of measurements and uniform definitions are needed to predict sickness absence and return to work in patients with CLBP.


Chronic low back pain Prediction Sick leave Systematic review 



The authors want to thank M.F. Reneman (PhD) for his comments on a previous version of this manuscript. This study was supported by grants of ‘Zorgonderzoek Nederland’, number 96-06-006, the Foundation ‘Beatrixoord Noord Nederland’ and the Foundation ‘De Drie Lichten’, the Netherlands.


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Copyright information

© Springer Science+Business Media, Inc. 2006 2006

Authors and Affiliations

  • Wietske Kuijer
    • 1
    • 2
    • 4
    Email author
  • Johan W. Groothoff
    • 1
    • 2
  • Sandra Brouwer
    • 1
    • 2
  • Jan H. B. Geertzen
    • 1
    • 2
  • Pieter U. Dijkstra
    • 1
    • 2
    • 3
  1. 1.Center for Rehabilitation, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
  2. 2.Northern Center for Healthcare Research, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
  3. 3.Department of Oral and Maxillofacial Surgery, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
  4. 4.Han UniversityFaculty of Health and Social StudiesGL NijmegenThe Netherlands

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