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Can Back Pain Prevention Programs Reduce Ecomonic Losses From Lower Back Pain Injuries?

Lower back pain (LBP), a common injury in Western society, has a significant economic impact as well as personal cost. In the United States alone, LBP has a total direct and indirect cost of $50 billion per year.

Researchers have been trying to find ways to lower the economic impact of back injuries. Earlier studies have indicated that early intervention with biopsychosocial education and treatment are more effective in aiding in recovery and maintaining general health than is the mantra of staying active, as is still recommended in some guidelines.

In this cluster, randomized, controlled trial, researchers evaluated if a prevention program for LBP had an effect on economic costs. The researchers recruited 489 workers from nine companies who were randomized to the study group (258) or to the control group (231). The researchers chose a multidimensional LBP prevention program based on integrating three preventative measures for the study group: three back training study sessions, immediate treatment of LBP through physical therapy and the workplace, and workplace visits for advising on ergonomic adjustments or additional training, if needed.

The workers filled out questionnaires regarding their lifestyle and work habits, and the researchers collected data regarding work absences, as well as pain intensity and functional limitations. At 12-month follow-up, results for 360 workers were available.

The researchers found that there was no difference in results from the study participants compared with those in the control group. Although there were fewer sick days due to complaints of pain in the upper body, there were no differences between the two groups regarding LBP in any of the outcome measurements.

Although the early intervention for prevention of LBP remains promising, the results of this study found no evidence supporting adoption of the particular program used. The authors do point out, however, that there are possible reasons that the study may not have found the program effective. They stated that the sample size may have had a negative effect, as did the use of sick days in the analysis. Although the researchers asked if the subject had lost work because of back pain, the answer may not have been truthful. The authors also pointed out that the program of immediate treatment and work-place adjustments may not have been strictly adhered to. Only 10 workers used the services of the in-house physiotherapy while 66 went off-site.


Helma I Jzelenberg, MSc, et al. Effectiveness of a Back Pain Prevention Program. In Spine. Vol.32. No. 7. Pp. 711-719.

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