The effect of work-focused rehabilitation among patients with neck and back pain: a randomized controlled trial

Spine (Phila Pa 1976). 2014 Nov 15;39(24):1999-2006. doi: 10.1097/BRS.0000000000000610.

Abstract

Study design: Multicenter randomized trial with patients listed as sick for 1 to 12 months due to neck or back pain and referred to secondary care.

Objective: To compare the return-to-work (RTW) rate among patients offered work-focused rehabilitation or multidisciplinary rehabilitation.

Summary of background data: A growing number of studies have focused on the RTW processes associated with patients with back pain. Many studies have combined a workplace focus with multidisciplinary treatments; however, this focus has not been evaluated in Norway among patients with neck and back pain thus far.

Methods: A total of 405 patients who were referred to the spine clinics at 2 university hospitals in Norway were randomly assigned into work-focused and control intervention groups. The existing treatments at each hospital were used as the control interventions, which entailed either a comprehensive multidisciplinary intervention or a brief multidisciplinary intervention. The RTW rates and proportions were compared at 12 months.

Results: During the first 12 months after inclusion, 142 (70%) participants in the work-focused rehabilitation group and 152 (75%) participants in the control group returned to work. The median time to RTW was 161 days in the work-focused group and 158 days in the control group. A comparison of the work-focused and control interventions revealed a relative RTW probability (hazard ratio) of 0.94 (95% confidence interval = 0.75-1.17) after adjusting for age, sex, and education.

Conclusion: The results suggest that a focus on the workplace in specialist care does not substantially alter the RTW rate compared with standard multidisciplinary treatments.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Back Pain / rehabilitation*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neck Pain / rehabilitation*
  • Prospective Studies
  • Rehabilitation / methods
  • Return to Work*
  • Sick Leave
  • Time Factors