Lowering the Cost of Low Back PainLow back pain results in a huge number of missed workdays and millions of dollars in health care costs each year. Health care professionals are always looking for ways to lower the cost of low back pain. These researchers tested the effectiveness of a "mini-intervention" and a work site visit in helping keep people with low back pain on the job.
The study involved 164 employed patients in Finland who had low back pain for four to 12 weeks. The patients were divided into three groups. All three groups got a brochure explaining how to deal with low back pain. The control group got standard medical care.
The mini-intervention group had a 1.5-hour session with a doctor and physical therapist. These patients were given positive messages about their ability to get better. They were told about the importance of staying active and shown ways to modify their work and home activities to protect their backs. They were also given up to five exercises to do at home.
The third group had the mini-intervention, too. Each patient in the third group also got a visit from the physical therapist on the job. If possible, the physical therapist included the supervisor and company medical personnel in the meeting. The physical therapist spent over an hour helping the patient modify work tasks to help keep the back healthy.
All three groups answered questions about their back pain after three months, six months, and one year. The researchers looked at the number of sick days the patients took and the health care services they used. All three groups reported similar levels of pain, disability, and quality of life. However, both intervention groups had less daily pain and less interference with regular activities. They were more satisfied with their medical care. They also used fewer sick days and used less health care services. The work visit didn't seem to make a significant difference in the outcomes between the two intervention groups.
The economic analysis showed that the mini-intervention alone resulted in significantly lower health care costs. Factoring in fewer sick days, it had an even bigger economic impact. The authors conclude that putting some money and energy into early treatment of low back pain can help keep costs down in the end.
Kaija Karjalainen, MD, et al. Mini-Intervention for Subacute Low Back Pain: A Randomized Controlled Trial. In Spine. March 15, 2003. Vol. 28. No. 6. Pp. 533-541.
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