The work hardening program and subsequent return to work of a client with low back pain

Billions of dollars are spent annually for the costs associated with workers' compensation cases. Chronic low back injuries have been traditionally the most costly cases. In addition to the physical problems, psychosocial issues emerge which confound conventional treatment and prolong resolution. Work hardening programs were developed to address the many issues of the occupationally injured chronic patient. This case study examines the treatment of a 54-year-old male who sustained an injury to his lumbar spine during employment as a boiler mechanic and subsequently had been out of work for 8 months. The article describes the interdisciplinary work hardening treatment (5-week duration) and the progressive resistive work circuit which preceded the client's return to work. It is concluded that work hardening programs can be cost-effective for insurers, as in this case, saving an estimated $44,000. An aggressive return to work program should also be considered in earlier stages of injury as a way of preventing the development of chronic disability for which the human costs are immeasurable.