Back pain: treatment and prevention in a community hospital

Because back pain is a widespread and costly condition that tends to recur, treatment must focus on both the amelioration of acute symptoms and prevention over the long term. This paper reports a longitudinal evaluation of a program from a community hospital that emphasizes both these aspects. One hundred twenty patients routinely admitted to this program were randomly assigned to treatment and control groups. These groups were assessed for differences in demonstrated physical strength, mobility, body mechanics, and self-care knowledge, and in levels of self-reported exercise, anxiety, and pain. There were significant immediate gains on physical measures of fitness and in observed body mechanics; patients also reported significant gains in physical capabilities at home and in leisure activities. Self-care knowledge also improved. When assessed one year later, original gains in physical strength and mobility were being maintained, and self-reported physical capabilities also remained high. Although demonstrated knowledge of correct body mechanics declined over this period, it was still significantly greater than before the program. In light of these results, we believe that outpatient programs like the one reported here merit careful consideration in an era of concern about rising costs for primary health care.