Journal ArticleDOI
A population-based, randomized clinical trial on back pain management
Patrick Loisel,Lucien Abenhaim,Pierre Durand,John M. Esdaile,Samy Suissa,Lise Gosselin,Robert Simard,Jean Turcotte,Jacques Lemaire +8 more
TLDR
Close association of occupational intervention with clinical care is of primary importance in impeding progression toward chronicity of low back pain.Abstract:
STUDY DESIGN Population-based randomized clinical trial. OBJECTIVES To develop and test a model of management of subacute back pain, to prevent prolonged disability. SUMMARY OF BACKGROUND DATA The present management of back pain seems inadequate, and development of innovative models has been urged. METHODS A model for the treatment of subacute work-related back pain has been developed and evaluated in a population-based randomized clinical trial. Workers (n = 130) from eligible workplaces in the Sherbrooke area (N = 31), who had been absent from work for more than 4 weeks for back pain, were randomized, based on their workplace, in one of four treatment groups: usual care, clinical intervention, occupational intervention, and full intervention (a combination of the last two). The duration of absence from regular work and from any work was evaluated using survival analysis. Functional status and pain were compared at study entry and after 1 year of follow-up. RESULTS The full intervention group returned to regular work 2.41 times faster than the usual care intervention group (95% confidence interval 1.19-4.89; P < 0.01). The specific effect of the occupational intervention accounted for the most important part of this result, with a rate ratio of return to regular work of 1.91 (95% confidence interval = 1.18-3.10; P < 0.01). Pain and disability scales demonstrated either a statistically significant reduction or a trend toward reduction in the three intervention groups, compared with the trend in the usual care intervention group. CONCLUSIONS Close association of occupational intervention with clinical care is of primary importance in impeding progression toward chronicity of low back pain.read more
Citations
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Journal ArticleDOI
The Oswestry Disability Index.
Jeremy Fairbank,Paul Pynsent +1 more
TL;DR: The ODI remains a valid and vigorous measure and has been a worthwhile outcome measure, and the process of using the ODI is reviewed and should be the subject of further research.
Journal ArticleDOI
Non-specific low back pain
TL;DR: Two treatment strategies are currently used, a stepped approach beginning with more simple care that is progressed if the patient does not respond, and the use of simple risk prediction methods to individualise the amount and type of care provided.
Journal ArticleDOI
The Roland-Morris Disability Questionnaire and the Oswestry Disability Questionnaire.
Martin Roland,Jeremy Fairbank +1 more
TL;DR: These two widely used measures, the Roland–Morris Disability Questionnaire (RDQ) or the Oswestry Disability Index (ODI), are described and evidence of their validity and reliability and some comparative results obtained with the use of the two questionnaires are provided.
Journal ArticleDOI
Workplace-Based Return-to-Work Interventions: A Systematic Review of the Quantitative Literature
TL;DR: The evidence base supporting that workplace-based RTW interventions can reduce work disability duration and associated costs is provided, however the evidence regarding their impact on quality-of-life outcomes was much weaker.
Occupational health guidelines for the management of low back pain at work – evidence review
Anthony Burton,Gordon Waddell +1 more
TL;DR: A systematic review of the literature to inform the development of occupational health guidelines for the management of low back pain at work is presented in this article, where the strongest evidence suggests that generally the physical demands at work have only a modest influence on the incidence of LBP or permanent spinal damage; preventive strategies based on the injury model do not reduce LBP, individual and work-related psychosocial factors play an important role in persisting symptoms and work loss; the management approach should be 'active' (including early work return); the combination of clinical, rehabilitation and organisational interventions
References
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1987 Volvo Award in Clinical Sciences: A New Clinical Model for the Treatment of Low-Back Pain
TL;DR: Observations of natural history and epidemiology suggest that low-back pain should be a benign, self-limiting condition, that low back-disability as opposed to pain is a relatively recent Western epidemic, and that the role of medicine in that epidemic must be critically examined.