Workplace changes in successful rehabilitation.

There is a lack of rehabilitation programs that also involve the workplace as a significant variable. Epidemiologic studies have pointed out aspects of the work environment that are risk factors for developing musculoskeletal disorders, delaying return to work, and for promoting relapse. An understanding of risk factors and the ability to identify and alter them is the basis for effective rehabilitation and prevention programs. Workplace changes should comprise organizational and psychosocial aspects, as well as the physical work conditions. Positive attitudes of managers and supervisors toward early return to work need to be emphasized. Several studies stress the importance of new or changed work tasks for a positive prognosis. Opportunities for the individuals to influence their own rehabilitation process may improve the outcome. A promising approach, based on a problem-based rehabilitation strategy, is presented as an attempt to integrate present knowledge from etiologic studies and from rehabilitation studies, respectively.