Adding a physical exercise programme to brief intervention for low back pain patients did not increase return to work

Abstract

Aims: To investigate if a standardised physical exercise programme given in addition to a brief intervention at a spine clinic had an effect on return to work.

Methods: A total of 246 patients sick-listed 8-12 weeks for non-specific low back pain were offered a brief intervention programme at the spine clinic with examination, information, reassurance, and encouragement to engage in physical activity as normal as possible, before they were randomised into an intervention group (n = 124) and a control group (n = 122). Patients in the intervention group participated in a physical exercise programme at the spine clinic.

Results: During the 2-year follow-up, there were no significant differences between the groups on sick leave, pain, use of analgesics, psychological distress, coping strategies, fear-avoidance beliefs, self-reported disability, or walking distances. However, both groups increased return to work, reported less pain and better function, and reduced fear-avoidance beliefs for physical activity during the follow-up period. Fear-avoidance beliefs for work were not changed.

Conclusions: A physical exercise programme for low back pain patients given after a brief intervention at a spine clinic did not have any additional effect on sick leave or fear-avoidance beliefs. Both groups reported less pain, better physical function, and increased return to work during follow-up. The treatment at the spine clinic did not contain a vocational rehabilitation programme directed towards individual work-related problems, which might explain no change in fear-avoidance beliefs for work.