What do low back pain and a head cold have in common? They are the top two reasons for visits to the doctor. There's also no known cure for either one. With that in mind, researchers continue to look for a cure for the common cold and ways to treat low back pain.
In this study 457 back pain patients were divided into two groups. One group was examined at a spine clinic. They were told more about back pain and given advice to stay active. The second (control) group was given regular care but not at the spine clinic. No special advice was offered the control group.
The theory behind this study is based on what happens to patients who still have back pain after two months. Fear of moving and new injury to the spine leads to inactivity. The longer a patient is off work, the greater the chance of chronic pain. Getting back to work depends on an early recovery.
A previous study by this same group has already shown one-year benefits from light activity. Returning to work and regular activity is linked with fewer sick days. The current study looks at the effects over three years. The authors want to know answers to several questions. Do the benefits of early activity last? Does early activity cause more injury later? Does it cost more or less to send a worker in group one back to the job after back pain?
The authors found a faster return to work in the group given light activity. This group also had fewer sick days. After six months the active group was still stretching and walking. After 12 months the active group was still stretching. The difference only lasted for the first year. During years two and three, both groups reported equal activity. Reinjury rates were high in both groups. Most patients had at least one or two new bouts of back pain during the three years.
There was a cost savings between the two groups. The active group cost $2,822 less in sick leave. They used fewer sick days during the first year and over the total three years. These numbers could be measured because the study was done in Norway where there is a national social insurance system. This savings reflects a cost-benefit to society.
The authors conclude that giving low back pain patients coping skills to manage their pain is cost effective in the first 12 months. Giving patients information and reassurance along with advice to keep active saves money by reducing the number of worker sick days. The researchers think this is worth it, even when the effects only last a year.
Eli Molde Hagen, MD, et al. Does Early Intervention with a Light Mobilization Program Reduce Long-Term Sick Leave for Low Back Pain: A 3-Year Follow-up Study. In Spine. October 15, 2003. Vol. 28. No. 20. Pp. 2309-2316.
