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


METHODS
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).


METHODS
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.


METHODS
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.


CONCLUSIONS
Long-term effects of active multidisciplinary treatment were superior to treatment as usual in all diagnostic groups.
Storrø
Sturla
S
Clinic of Physical Medicine 3T, Trondheim, Norway. sturla@fysmed.no
Moen
Janne
J
Svebak
Sven
S
D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000379:methods; D002908:Chronic Disease; D004651:Employment; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000534:rehabilitation*; D010348:Patient Care Team; D012046:Rehabilitation / Q000379:methods*; D020069:Shoulder Pain / Q000534:rehabilitation*; D018582:Sick Leave; D016896:Treatment Outcome