BOSTON – Psychosocial factors can hamper recovery from lower-back pain and be a stronger cost driver than some catastrophic injuries, analysts with the Workers Compensation Research Institute said Tuesday.

These risk factors, which include fear of pain due to activity, negative coping, job dissatisfaction, perceived injustice and stressful work, as well as family and support system issues, can negatively affect recovery time for workers comp claimants dealing with lower back injuries, researchers said during a panel discussion at the 2024 WCRI Issues & Research Conference.

Researchers found a strong association between psychosocial risk factors and a longer duration of functional recovery after physical therapy care.

The findings, from data collected between 2017 and 2022, determined that workers comp patients had a higher prevalence of psychosocial risk factors than other patient populations.

Researchers found that one in three injured workers with low back pain were flagged as high-risk for psychosocial factors, higher than low-back-pain patients using private insurance or Medicare.

The differing functional outcomes depending upon payor type were attributed to factors such as socio-demographics, finances and comorbidities.

Workers comp claimants with elevated psychosocial risk factors had a lower likelihood of meaningful improvements in function, and many had a higher likelihood of “very limited” function at the time of discharge from physical therapy, said Vennela Thumula, a WCRI policy analyst.

Previous studies addressing psychosocial risk factors as they relate to functional recovery in low-back injury cases looked primarily at non-workers comp patient populations, “and the results varied widely,” said Randall Lea, a WCRI senior research fellow.

Unlike prior research, the latest study used a larger sample size, Mr. Lea said.

“We don’t know how often providers are screening for psychosocial factors,” he said.

The panelists said future studies could look at the psychosocial issue as it relates to different provider types and interventions other than physical therapy.

“It would be interesting to see if these trends hold true in other combinations,” Mr. Lea said.