title: Retention in physically demanding jobs of individuals with low back pain: study protocol for a randomised controlled trial.
abstract: BACKGROUND
  Low back pain is prevalent and is a frequent cause of disability and sick leave among working adults. Individuals with low back pain often consult general practice or other health care providers which often results in a unilateral intervention focussed on their symptoms. Employment is associated with physical and mental well-being, so, patients may benefit from an early additional occupational medicine intervention. For individuals with physically demanding jobs it can be especially challenging to retain their jobs. The aim of the 'GoBack trial' is to develop and evaluate the efficacy and feasibility of an occupational medicine intervention for individuals with low back pain in physically demanding jobs.
  
  
  METHODS
  We will conduct a randomised controlled trial enrolling 300 participants with difficulty in maintaining physically demanding jobs due to low back pain for a current period of 2 to 4 weeks. Participants will be randomised and stratified according to their age and gender before being allocated in a 1:1 ratio to either control or additional occupational medicine intervention. Both groups will receive conventional treatment for their low back pain during the study. All participants will be thoroughly assessed for causes of low back pain and potential prognostic factors by questionnaires, clinical specialist assessments and magnetic resonance imaging (MRI) scans of the lumbar spine. Primary outcome is the accumulated duration of self-assessed sick leave (in days) due to low back pain during 6 months from baseline. Secondary outcomes include general self-rated back pain, disability and screening for potential prognostic factors: fear avoidance behaviour, disability, health status and degenerative MRI findings. For tertiary purposes selected outcomes will also be assessed after 1 and 2 years from baseline.
  
  
  CONCLUSIONS
  Many guidelines exist for the management of low back pain, but they provide limited guidance on occupational aspects. The findings from this randomised trial will provide high-quality evidence for the efficacy and feasibility of an occupational medicine intervention model for individuals with low back pain in physically demanding jobs.
  
  
  BACKGROUND
  This trial was registered with ClinicalTrials.gov (identifier: NCT02015572 ) on 29 November 2013.
authors.affiliation: Department of Rheumatology, The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg, Copenhagen, Denmark. bjarke.hansen.01@regionh.dk.
authors.forename: Bjarke Brandt
authors.initials: BB
authors.lastname: Hansen
authors.affiliation: Department of Occupational and Environmental Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, DK-2400, Copenhagen, NV, Denmark. Lilli.Kirkeskov@regionh.dk.
authors.forename: Lilli
authors.initials: L
authors.lastname: Kirkeskov
authors.affiliation: Department of Rheumatology, The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg, Copenhagen, Denmark. robin.christensen@frh.regionh.dk.
authors.forename: Robin
authors.initials: R
authors.lastname: Christensen
authors.affiliation: Department of Occupational and Environmental Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, DK-2400, Copenhagen, NV, Denmark. Luise.Moelenberg.Bergtrup@regionh.dk.
authors.forename: Luise Mølenberg
authors.initials: LM
authors.lastname: Begtrup
authors.affiliation: Department of Occupational and Environmental Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, DK-2400, Copenhagen, NV, Denmark. Ellen.Boetker.Pedersen@regionh.dk.
authors.forename: Ellen Bøtker
authors.initials: EB
authors.lastname: Pedersen
authors.affiliation: Department of Occupational and Environmental Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, DK-2400, Copenhagen, NV, Denmark. Jakob.falk.teilya@regionh.dk.
authors.forename: Jakob Falk
authors.initials: JF
authors.lastname: Teilya
authors.affiliation: Department of Radiology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Nordre Fasanvej 57, 2000, Frederiksberg, Copenhagen, Denmark. mikael.boesen@gmail.com.
authors.forename: Mikael
authors.initials: M
authors.lastname: Boesen
authors.affiliation: Department of Rheumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Nordre Fasanvej 57, 2000, Frederiksberg, Copenhagen, Denmark. gilles.ludger.fournier@regionh.dk.
authors.forename: Gilles Ludger
authors.initials: GL
authors.lastname: Fournier
authors.affiliation: Department of Rheumatology, The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg, Copenhagen, Denmark. Henning.Bliddal@regionh.dk.
authors.forename: Henning
authors.initials: H
authors.lastname: Bliddal
authors.affiliation: Department of Occupational and Environmental Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, DK-2400, Copenhagen, NV, Denmark. ann.isabel.kryger@regionh.dk.
authors.forename: Ann Isabel
authors.initials: AI
authors.lastname: Kryger
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000328:Adult; D000368:Aged; D002985:Clinical Protocols; D003718:Denmark; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007587:Job Description; D017116:Low Back Pain / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010348:Patient Care Team; D010563:Personnel Turnover; D012107:Research Design; D062707:Return to Work; D018582:Sick Leave; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014938:Work Capacity Evaluation; D016526:Workload; D055815:Young Adult