Lower Back Pain: When Will You Get Back To Work?

By Dr Ken Nakamura+

Lower Back Pain Recovery& Prognosis -Toronto Downtown Chiropractor

You’ve just put out your lower back and you want to get back to work. What determines when you will get back to work?


How will you prevent a reoccurrence of lower back pain?


In this issue of Bodi Empowerment this Toronto downtown chiropractor answers all these questions and more.


The likely course of your lower back pain is called a prognosis.


The good news is most of you will improve markedly in the first six weeks. The bad news is that after the first six weeks most people improve more slowly up to 3 months, with many of you having some pain and disability even after one year [1][2].


Surprisingly even people like yourself with acute lower back pain return to work within one month. Unfortunately most of you will have one re-ocurrence and you will have to live with the pain for at least 12 months.


See Also: Sciatica Exercises For Your Lower back and Leg Pain



You don’t have to live that way. Everything I said above is true for people that do nothing about their pain. If you get treatment you can change your prognosis.


What will change my outlook for my lower back?

Lower Back Pain Has Two Main Factors That Determine Your Prognois.

Physical Factors and Psychological Factors

The Physical [3].


  • Age: With age your disc and joints break down more giving you increased chance of lower back pain.


  • Intensity of pain: The more severe the pain is the more likely that you will have a longer recovery period.


  • Poor general health. High blood pressure, high cholesterol, bad sleep, stress, diabetes, and any other disease will slow your progress.


  • Lifting: The amount of lifting and how you lift during your recovery will determine when you get back to work.


  • Work postures: The more forward bending or side bending postures you have to sustain the worse for your lower back.


See Also: Part 1 Disc Herniation Exercises


  • Repeated Forward bending: The more forward bending that you have to do during work or at home, the more likely that you have a more serious injury when you do get pain [3].


  • A history of low back pain.


  • The longer you were off with a low back pain in the past the more likely you will be off for longer in the future.


  • Spinal Surgery for lower back pain in the past makes you more likely the prognosis will be longer.


Phychological [4]


  • Preceived risk of not recovering. This means that if you feel you won’t recover chances are you won’t. The mind is very powerful.


  • Psychological factors such as distress [4].


  • Work related factors such as job satisfaction.


See Also: Part 2 Disc Herniation Exercises


  • Employment status- If you are employed you are more likely to make a comeback. Based on my own experience with patients it makes a difference if you are self-employed or not. Self-employed people get back to work faster. They don’t get paid if they take a day off, so they get back to work earlier, sometimes to their detriment.


  • Your Wage:


  • Workers’ compensation: People on workers compensation take longer to recover from lower back pain.


  • Depression: Depression makes recovery more difficult as you keep thinking of bad scenarios in your head. eg.or simply think you won’t recover ie the voice in your head tells you that your pain is here to stay.



Tell us what you think in the comments below and like us on Facebook. This Toronto Downtown Chiropractor will answer all questions in the comments section. 



[1]Acute Low Back Pain: Systematic Review of its prognosis BMJ v.327(7410); Aug 9, 2003

[2] Menezes Costa Lda, C; Maher, CG; Hancock, MJ; McAuley, JH; Herbert, RD; Costa, LO (7 August 2012). “The prognosis of acute and persistent low-back pain: a meta-analysis.”. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne 184 (11): E613 24. doi:10.1503/cmaj.111271. PMC 3414626. PMID 22586331.

[3]Spine (Phila Pa 1976). 2003 Dec 1;28(23):2634-40. Outcome determinants of subacute low back pain.

[4] Chronicity, recurrence, and return to work in low back pain: common prognostic factors.
Ann Readapt Med Phys. 2004 May;47(4):179-89.



Dr Ken Nakamura

4 Responses to Lower Back Pain: When Will You Get Back To Work?
  • Larry says:
    January 23, 2014 at 8:22 pm

    Thank you for the advice. Just gets frustrating lol

    • Dr Ken Nakamura says:
      January 24, 2014 at 12:35 am

      You are on your way healing Larry. I hope you feel better quickly. If you have any other questions let me know.

  • Larry says:
    January 23, 2014 at 10:39 am

    Hello dr. I Herneated my disc doing bent rows 8weeks ago. I have no pain just weakness in right calf and a little foot drop I was told walking was good. I walked today maybe a quarter mi and my calf and foot got vary weak. Am I just not ready to walk a distance yet ? It would be much appreciated if u would send me a answer thanks

    • Dr Ken Nakamura says:
      January 23, 2014 at 11:11 am

      Thanks for your thoughts Larry. Disc herniations are usually painful so you are lucky that your lower back is not painful. The disc can still pinch the nerve enough to weaken the foot causing foot drop. This means that the L5 nerve is affected, with quite a lot of pressure on the nerve. It can be a disc but there are a number of other possible causes for foot drop like stenosis (narrowing of the opening for the nerve leading to the sciatic nerve). In most cases walking is a good idea as it takes the pressure off the nerve compared to sitting. Lying down is the least pressure on the nerve, standing is a little more pressure and sitting is more pressure still, and forward bending (like putting on a sock) is the most pressure on your disc. Lifting objects while bent forward is the ideal way to make your disc herniation worse.

      I recommend a combination of positions to take pressure off the nerve. Don’t sit for more than an hour, stand and walk whenever you can but up to the point where you get weak. ie. if you get weak after a 10 minute walk, then turn around at the 5 minute mark. What I am saying is there is no magic position when it comes to a disc herniation.

      If you want to find out in detail about disc herniations then you should read, https://www.bodiempowerment.com/low-back-pain/disc-herniation-part-1/. This article is mainly about the causes and what to avoid.

      For the exercises for disc herniations read this article: https://www.bodiempowerment.com/low-back-pain/herniated-disc-part-2-the-best-exercises-for-your-herniated-disc/

      For proper bending and lifting read this article: https://www.bodiempowerment.com/low-back-pain/weight-lifting-techniques-smarter-than-chiropractors-how-to-use-back-safety-lifting-techniques/

      Hope that helps.

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