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Editorials |

Absent from Work: Nature versus Nurture

James Weinstein, DO, MS
[+] Article and Author Information

From Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756.


Potential Conflicts of Interest: None disclosed.

Requests for Single Reprints: James Weinstein, DO, MS, Department of Orthopedics, Dartmouth Medical School, Dartmouth–Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756.


Ann Intern Med. 2004;140(2):142-143. doi:10.7326/0003-4819-140-2-200401200-00016
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Low back pain is common and costly. It is a leading cause of chronic pain and an inordinately frequent cause of disability and lost productivity. According to a recent survey of U.S. workers, those who lost time because of back pain in the previous 2 weeks reported losing an average of 5.28 hours of productive time per week (1). Back pain accounted for nearly $20 billion of lost productivity and ranked second only to headache as a reason for loss of productive time. According to this survey, most of the loss was not from absenteeism but from reduced performance at work. Unfortunately, lost productivity accounts for only part of the total estimated work-related cost of musculoskeletal conditions in the U.S. workforce. The rest is due to medical costs associated with an ongoing chronic disability (for example, effects of medication; visits to the doctor; diagnostic tests; surgery; or visits to a chiropractor, massage therapists, or acupuncturist), the cost of training replacement workers, and the company's cost of maintaining productivity as a whole.

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