Mini-intervention for subacute low back pain: a randomized controlled trial.
METHODS
Randomized controlled trial.


OBJECTIVE
To investigate the effectiveness and costs of a mini-intervention, provided in addition to the usual care, and the incremental effect of a work site visit for patients with subacute disabling low back pain.


BACKGROUND
There is lack of data on cost-effectiveness of brief interventions for patients with prolonged low back pain.


METHODS
A total of 164 patients with subacute low back pain were randomized to a mini-intervention group (A), a work site visit group (B), or a usual care group (C). Groups A (n = 56) and B (n = 51) underwent one assessment by a physician plus a physiotherapist. Group B received a work site visit in addition. Group C served as controls (n = 57) and was treated in municipal primary health care. All patients received a leaflet on back pain. Pain, disability, specific and generic health-related quality of life, satisfaction with care, days on sick leave, and use and costs of health care consumption were measured at 3-, 6-, and 12-month follow-ups.


RESULTS
During follow-up, fewer subjects had daily pain in Groups A and B than in Group C (Group A Group C, = 0.002; Group B Group C, = 0.030). In Group A, pain was less bothersome (Group A Group C, = 0.032) and interfered less with daily life (Group A Group C, = 0.040) than among controls. Average days on sick leave were 19 in Group A, 28 in Group B, and 41 in Group C (Group A Group C, = 0.019). Treatment satisfaction was better in the intervention groups than among the controls, and costs were lowest in the mini-intervention group.


CONCLUSIONS
Mini-intervention reduced daily back pain symptoms and sickness absence, improved adaptation to pain and patient satisfaction among patients with subacute low back pain, without increasing health care costs. A work site visit did not increase effectiveness.
Karjalainen
Kaija
K
Department of Occupational Medicine, Finnish Institute of Occupational Health, Helsinki, Finland. kaija.karjalainen@occuphealth.fi
Malmivaara
Antti
A
Pohjolainen
Timo
T
Hurri
Heikki
H
Mutanen
Pertti
P
Rissanen
Pekka
P
Pahkajärvi
Helena
H
Levon
Heikki
H
Karpoff
Hanna
H
Roine
Risto
R
D000208:Acute Disease; D000328:Adult; D004185:Disability Evaluation; D015444:Exercise; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D017116:Low Back Pain / Q000191:economics / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000191:economics / Q000706:statistics & numerical data*; D010147:Pain Measurement / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D026741:Physical Therapy Modalities; D011788:Quality of Life; D018582:Sick Leave / Q000706:statistics & numerical data; D017132:Workplace