Integrated Care Program Beneficial in Low Back Pain

Intervention group returned to work an average of 120 days earlier than usual-care group
By Rick Ansorge
HealthDay Reporter

WEDNESDAY, March 17 (HealthDay News) -- In patients with chronic low back pain, an integrated care program that combines a patient-directed and workplace-directed intervention may significantly reduce disability in private and working life, according to a study published online March 16 in BMJ.

Ludeke C. Lambeek, of the VU University Medical Center in Amsterdam, Netherlands, and colleagues randomly assigned 134 patients with low back pain to receive either the integrated care program or usual care.

The researchers found that the integrated-care group had a significantly shorter median duration until sustainable return to work than the usual-care group (88 versus 208 days), and that integrated care was effective on return to work (hazard ratio, 1.9). They also found that, after one year, the integrated-care group had significantly higher functional status even though there was no significant group difference in pain improvement.

"This applies to a selected group of patients with chronic low back pain, all of whom were judged appropriate for this kind of psychosocial treatment," the authors conclude. "The lack of effectiveness on pain confirms the validity of the work disability paradigm. This promising systems approach, directed to both the patient and the work environment, could have a great impact on the individual burden of low back pain."

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