Pre-Return-to-Work Condition Assessment After a Work Injury
Table of Contents
Why a pre-return assessment matters
Studies show that returning to work too quickly after a work injury increases the risk of recurrence by 40–60%. Musculoskeletal injuries in particular may look outwardly recovered, yet deep tissues need additional time for full healing. An objective pre-return assessment is essential to determine the safe time for return to work.
Residual pain assessment (NRS)
On the Numeric Rating Scale (NRS) of 0–10, return to work can be considered when pain is 2 or below at rest and 4 or below during activity. The pain score during a simulation of the actual job task is especially important. For example, for a worker handling heavy loads, we evaluate pain when lifting an object of the actual weight involved.
Functional recovery assessment
- Range of motion (ROM): Whether at least 80% of normal range has been recovered
- Strength testing: At least 80% of the unaffected side on manual muscle testing (MMT)
- Activities of daily living (ADL): Independent ability to perform washing, dressing, walking, and stair climbing
- Job-specific function: Ability to perform the motions required by the specific occupation
Checking for recurrence risk factors
If any of the following apply, return should be delayed or workload should be modified:
- Waking from sleep due to pain two or more times per week
- Pain worsens within 30 minutes of holding the same posture
- History of pain recurrence within 1 month after treatment closure
- Psychological anxiety — fear of returning to the workplace
Korean medicine support for return to work
For 4 weeks before returning, we recommend boosting overall stamina with Bojung-iggi-tang (Buzhong Yiqi Tang) or Sipjeondaebo-tang, while continuing acupuncture (1–2 times per week) at the injured site, and following a graded return in which workload is gradually increased. For the first 2 weeks after return, follow-up visits once a week monitor for signs of recurrence.