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December 16, 1998

Preventing Low Back Pain in Industry

JAMA. 1998;280(23):1993-1994. doi:10-1001/pubs.JAMA-ISSN-0098-7484-280-23-jbk1216

To the Editor.—The conclusions of the study by Ms van Poppel and colleagues1 are not unexpected. In 1972, Beals and Hickman2 reported the importance of psychological evaluation in rehabilitation efforts concerning industrial injuries to the back and extremities. The authors found psychological ratings by psychologists to be superior to ratings made by physicians in predicting return to work. In 1975, Wiltse and Rocchio3 reported the Minnesota Multiphasic Personality Inventory hysteria and hypochondriasis scales to be predictive of the result of lumbar chemonucleolysis and lumbar laminectomy. The surgeon's rating of the psychogenic component of the patient's pain was also predictive. In 1991, Bigos et al4 reported factors associated with increased likelihood of back pain or low back claims included job satisfaction, quality of interaction between the worker and his or her supervisor, and poor employee appraisal rating. I had a similar experience at the Department of Labor and Industries Rehabilitation Center in Seattle, Wash.