Effects on sick-leave of a multidisciplinary rehabilitation programme for chronic low back, neck or shoulder pain: comparison with usual treatment

Abstract

OBJECTIVE: To test the outcome of active multidisciplinary treatment in an outpatient setting upon sick-leave status among patients with neck, shoulder and low back pain. DESIGN: Multidisciplinary treatment was administered to 121 patients (intervention group) over 4 weeks of structured intervention, followed by 8 weeks of less structured consultations. Effects of treatment were compared with usual treatment (control group: n = 97). PATIENTS: All patients were in the chronic stage of pain (average sick-leave: 6 months) with different diagnoses: neck-shoulder pain, low back pain or low back pain with radiating extremity pain. METHOD: The intervention group programme included posture corrections, pain perception, skills to cope with pain, aerobic and fitness-promoting activities and relaxation techniques administered to groups of 8-10 patients. The Local National Insurance Office referred the patients who were diagnosed by general practitioners. A 12-month follow-up by the Local National Insurance Office provided feedback about sick-leave status of all 218 patients. RESULTS: There was a significant treatment difference in proportion taken off the sick list after 12 months (intervention group: 78.5%; control group: 50.5%; p < 0.001). The difference was greater among low back pain (p < 0.001) than among neck-shoulder (p < 0.053) and low back pain with radiating extremity pain (p < 0.031) patients. CONCLUSION: Long-term effects of active multidisciplinary treatment were superior to treatment as usual in all diagnostic groups.