The Effect of Work-Focused Rehabilitation Among Patients With Neck and Back Pain

Abstract

In Brief Study Design. Multicenter randomized trial with patients listed as sick for 1 to 12 months due to neck or back pain and referred to secondary care. Objective. To compare the return-to-work (RTW) rate among patients offered work-focused rehabilitation or multidisciplinary rehabilitation. Summary of Background Data. A growing number of studies have focused on the RTW processes associated with patients with back pain. Many studies have combined a workplace focus with multidisciplinary treatments; however, this focus has not been evaluated in Norway among patients with neck and back pain thus far. Methods. A total of 405 patients who were referred to the spine clinics at 2 university hospitals in Norway were randomly assigned into work-focused and control intervention groups. The existing treatments at each hospital were used as the control interventions, which entailed either a comprehensive multidisciplinary intervention or a brief multidisciplinary intervention. The RTW rates and proportions were compared at 12 months. Results. During the first 12 months after inclusion, 142 (70%) participants in the work-focused rehabilitation group and 152 (75%) participants in the control group returned to work. The median time to RTW was 161 days in the work-focused group and 158 days in the control group. A comparison of the work-focused and control interventions revealed a relative RTW probability (hazard ratio) of 0.94 (95% confidence interval = 0.75–1.17) after adjusting for age, sex, and education. Conclusion. The results suggest that a focus on the workplace in specialist care does not substantially alter the RTW rate compared with standard multidisciplinary treatments. Level of Evidence: 2 Patients listed as sick due to neck or back pain were included in a multicenter randomized trial conducted at 2 university hospitals in Norway. The primary outcome was the return-to-work (RTW) rate after work-focused or multidisciplinary rehabilitation interventions. The results did not suggest the presence of additional work-focused treatment effects with regard to the RTW rate.