Active treatment programs for patients with chronic low back pain: a prospective, randomized, observer-blinded study

Area of Science:

• Rehabilitation Medicine
• Pain Management
• Occupational Health

Background:

• Chronic disabling low back pain (LBP) presents a significant challenge.
• Active approaches and multidisciplinary programs based on the bio-psycho-social model show promise.
• The cost-effectiveness of intensive programs requires evaluation.

Purpose of the Study:

• To compare the rehabilitation outcomes of three distinct active programs for chronic LBP.
• To assess return-to-work rates, sick leave duration, healthcare utilization, pain, and disability.
• To determine the long-term effectiveness of an intensive multidisciplinary program versus less intensive alternatives.

Main Methods:

• 132 patients with chronic LBP were randomized into three groups.
• Group 1: Intensive 3-week multidisciplinary program (physical, ergonomic, psychological).
• Group 2: 6 weeks of active physical training (24h total).
• Group 3: 6 weeks of psychological pain management and active physical training (24h total).

Main Results:

• Data collected 4 months post-treatment from 123 patients (86% response rate).
• The intensive multidisciplinary program demonstrated superior return-to-work rates.
• Significant improvements were observed in healthcare contacts, pain and disability scores, and physical activity levels compared to less intensive programs.

Conclusions:

• An intensive, multidisciplinary approach is more effective for chronic LBP rehabilitation.
• This program positively impacts return-to-work, pain, disability, and physical activity.
• The findings support the value of comprehensive programs despite higher initial costs.