Integrated care can cut chronic back pain work disability by 4 months

An integrated care program directed at the employee and workplace can help individuals with chronic low back pain return to work an average of four months earlier than those receiving usual care, according to a study.

Although the prospect of returning to work is generally good for employees with low back pain, up to a quarter of individuals remain absent from work in the long term, according to researchers from The Netherlands and Canada. This results in 75 percent of the costs due to sick leave and disability, they said.

In the study, published in the British Medical Journal, researchers set out to evaluate the effectiveness of an integrated care program in 134 patients with chronic low back pain. All individuals were between 18 and 65 years of age and had been absent from work due to low back pain an average of nearly a half year.

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Participants were randomly assigned to either usual care or integrated care. Integrated care consisted of adjustments to the workplace and a graded exercise program to teach employees how to move safely while increasing activity levels. The aim of the program, researchers said, was to restore occupational functioning and to achieve lasting return to work for patients in their own job or similar work. The usual care group, on the other hand, received normal pain treatment with usually little or no workplace involvement.

Individuals also completed questionnaires at the start of the study and after three, six, nine and 12 months. Sickness absence data were collected every month.

Over the yearlong study period, individuals who received integrated care returned to sustainable work after an average of 88 days compared with 208 days for patients receiving usual care. After 12 months, employees in the integrated care group also improved significantly more on functional status compared to individuals in the usual care group. Researchers found no statistically significant differences in pain improvement between the two groups.

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April 29, 2010

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