When’s The Best Time For Work Disability Intervention?

Researchers question the long-held notion of the subacute injury phase to be the “golden hour” for return to work interventions.

When treating work-related injuries, when is the best time to integrate interventions that facilitate a return to work for the injured party?  Specifically, with low back injuries, some have deemed the subacute phase as “the golden hour” to apply said interventions to prevent work disability. This premise arose based on literature published up until 2001 and is limited to back pain.

return to work

However, a recent narrative review takes a look at this premise by examining literature published from 1997 to April 2018, primarily focused on randomized controlled trials assessing effects of occupational rehabilitation interventions for musculoskeletal complaints (15 included), and mental health disorders (9 included).  The authors were trying to determine if more recent literature supports the notion that there’s an optimal time for return to work (RTW) interventions.  The study examined participants’ sick leave duration and the point at which RTW-interventions were implemented. 

Results were mixed –  some literature supported the introduction of RTW-interventions for musculoskeletal injuries in the subacute phase, but more recent evidence shows that “RTW-interventions also can be effective for workers with longer sick leave durations.” Therefore, the notion that there’s a “golden hour” to introduce RTW-interventions for work disability prevention may be flawed.  Instead of assuming a narrow “golden hour” for RTW-interventions, the authors suggest that a better question to ask is:  What’s the RIGHT type of intervention, and at what time, for whom?  This would take into consideration the specifics about the injured individual, their TYPE of injury and their health history. The authors suggest that further research is needed in order to measure the effects of RTW-interventions administered at different time frames, to determine the best options for facilitating a return to work and avoid extended disability.

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