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An Armful of Hints to Help Get Injured Workers Back on the Job

Why is it that some people who hurt themselves return to work and others don't? This has puzzled doctors, employers, and worker's compensation personnel for years. The cost of the injury isn't as much as the indirect costs of lost work. In fact, lost productivity costs twice as much as the direct health care costs for an injury.

Doctors would like to be able to predict who will have a good recovery. If they can tell who won't be able to return to work, the patients can be retrained or directed to some other kind of work. The earlier this is done, the better for patients and costs.

A group of doctors in the Netherlands studied this problem. They compared workers with arm injuries who did return to work with those who didn't. They found that there are some factors that make a difference. For example, if the injury is above the elbow, the chances of returning to the same job are less than if the injury is in the hand.

Having more than one nerve or one tendon injured increases the risk of a poor result. Two nerves in the arm were compared: the median and ulnar nerves. Damage to the ulnar nerve usually has a greater effect on grip strength. Grip strength is an important skill needed to return to most jobs.

Other important risk factors included education level and rehabilitation. Workers with a higher level of education and training go back to work sooner than blue-collar workers or manual laborers. Most of all, workers given a rehab program were 3.5 times more likely to return to work within one year of the injury.

The authors of this study think that compliance with a hand therapy program may be the key to returning workers with arm injuries to the job. Retraining or redirecting workers who have the risk factors outlined above can reduce costs.

References: Coen N. P. Bruyns, MD, et al. Predictors for Return to Work in Patients With Median and Ulnar Nerve Injuries. In The Journal of Hand Surgery. January 2003. Vol. 28A. No. 1. Pp. 28-34.

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