BackgroundPrognosis of musculoskeletal disorders following injury is essential in determining appropriate treatment and care. A generic validated prognostic tool to stratify risk of poor recovery for people with musculoskeletal injuries after road traffic crash is not available. This study aimed to examine differences in recovery, return to work and health related quality of life between low and high-risk of poor recovery people with musculoskeletal injuries stratified by the Short form - Örebro Musculoskeletal Pain Screening Questionnaire (SF-OMPSQ).MethodsIn an inception cohort study, participants with non-fracture musculoskeletal injury with the main site being the neck, lower back or lower limb were stratified into low (score ≤ 50) and high (score > 50) risk of poor recovery using the SF-OMPSQ score at baseline. We assessed the proportion of fully recovered participants (Global Perceived Effect scale ≥4), the proportion returning to work and changes in short form 12-item (SF-12) scores between baseline and 6-month follow-up in low and high-risk groups. Modified Poisson regression was used to estimate the adjusted risk ratio (RR) of being recovered and return to work in the low and high-risk groups. Paired t-test was used to compare changes in SF-12 physical and mental component summary scales, and chi-square test was used to assess the significance of the risk ratio of fully recovered between low and high-risk groups.ResultsThe study included 498 participants (166 with neck, 78 with lower back and 254 with lower limb injuries). The proportion of being recovered was significantly higher in the low than the high-risk groups (Adjusted risk ratio: 2.96 [95% CI: 1.81 to 4.82]). Significantly more people in the low-risk group returned to work (91.0%) than the high-risk group (54.6%). People at low-risk had higher SF-12 scores at baseline and 6-month follow-up than those at high-risk. There were no differences between injury types for recovery and return to work at 6 months.ConclusionThe SF-OMPSQ could be recommended as a generic prognostic tool to identify individuals with musculoskeletal injuries early after road traffic injury, who would have a higher or lower likelihood of recovering or returning fully to pre-injury work.Trial registrationAustralia New Zealand Clinical trial registry identification number - ACTRN12613000889752. Registered 09 August 2013.