Adding a physical exercise programme to brief intervention for low back pain patients did not increase return to work

Area of Science:

• Rehabilitation Medicine
• Occupational Health
• Clinical Biomechanics

Background:

• Non-specific low back pain (LBP) is a leading cause of disability.
• Return to work (RTW) is a key outcome for LBP patients.
• Standardized exercise programs are often recommended, but their added benefit post-intervention needs clarification.

Purpose of the Study:

• To determine if a standardized physical exercise program, in addition to a brief spine clinic intervention, impacts return to work rates.
• To assess the effect on secondary outcomes including pain, function, and fear-avoidance beliefs.

Main Methods:

• 246 patients with LBP (8-12 weeks sick leave) received a brief spine clinic intervention.
• Patients were randomized into an intervention group (physical exercise program) or a control group.
• Outcomes were assessed over a 2-year follow-up period.

Main Results:

• No significant differences were observed between groups for sick leave, pain, analgesic use, psychological distress, coping, fear-avoidance beliefs, or self-reported disability.
• Both groups demonstrated improvements in return to work, reduced pain, and enhanced physical function.
• Fear-avoidance beliefs specifically related to work did not change in either group.

Conclusions:

• A standardized physical exercise program following a brief spine clinic intervention does not offer additional benefits for sick leave or fear-avoidance beliefs in LBP patients.
• Improvements in pain, function, and return to work were observed in both intervention and control groups, suggesting the initial brief intervention was beneficial.
• The lack of change in work-related fear-avoidance beliefs may be due to the absence of specific vocational rehabilitation within the spine clinic treatment.