Abstract
Non-specific chronic low back pain (CLBP) restricts participation in society and employment also due to the high psychosocial burden of this condition. Thus, there is an urgent need for rehabilitation of patients with CLBP, which must be determined by a valid diagnosis of psychosocial risk factors. The subjective prognosis of gainful employment (SPE) is considered to indicate the need for medical rehabilitation for back pain. The present study investigated the association between SPE and psychosocial risk factors among individuals with non-specific CLBP undergoing inpatient multidisciplinary orthopedic rehabilitation (MOR).This cross-sectional observational study included 925 individuals aged 20 to 65 with non-specific CLBP at admission to inpatient MOR (M=52.2 years, SD=7.2; 77.5% female; ICD-10: M51/53/54). Associations of the SPE total score with psychological, pain-related, and work-related measures were examined by using correlation and regression analyses. Moreover, moderated associations of the SPE categorical score were tested using one-way analyses of variance with the independent factor self-reported prognosis of employment (favorable vs. unfavorable). Additionally, the frequency distributions of scores within the clinical range for depressive symptoms, chronic stress, and subjectively assessed work ability stratified by self-reported prognosis of employment were investigated.A less favorable self-reported prognosis of employment was predicted by higher job strain and chronic stress as well as lower pain self-efficacy and subjective physical work ability. In particular, individuals with an unfavorable self-reported prognosis of employment showed a risk pattern and were frequently in the clinical range for depressive symptoms, chronic stress, and subjective work ability.The results supported a high need for rehabilitation for this target group, especially for patients with non-specific CLBP and unfavorable self-reported prognosis of employment. Early assessment of sociomedical criteria, in addition to pain and psychodiagnosis as well as targeted referral to needs-based interdisciplinary multimodal treatment approaches could reduce the risk of further chronification of pain and the development of mental disorders.