Q: I've been off work with low back pain for the last six weeks. I'm better now but not pain free. How do I know when it's safe to go back to work?

A: According to a recent study from the Netherlands, most low back pain (LBP) patients return to work (RTW) before their symptoms are completely gone. Going back to work does not cause more harm than staying home on sick leave.

People who have had a previous episode of back pain RTW earlier compared to patients having their first bout of LBP. This may be because they have learned how to handle it.

It is possible that going back to work actually helps patients recover even more. More research is needed to prove this. For now it's clear that RTW is linked most directly to function. In other words, RTW occurs when the patient can perform the movements and tasks required by the job.

If your job is physically demanding, then you may want to seek the advice of a physiotherapist trained to make work assessments. The therapist will test you to see how closely your strength, endurance, and skill match those required by your job. Sometimes an intermediary rehab program is needed to transition patients back to work safely.

Elske Faber, MSc, et al. Determinants for Improvement in Different Back Pain Measures and Their Influence on the Duration of Sickness Absence. In Spine. June 1, 2006. Vol. 31. No. 13. Pp. 1477-1483.