Comparison of three intensive programs for chronic low back pain patients: a prospective, randomized, observer-blinded study with one-year follow-up

Abstract

In a randomized, blinded study, we compared the outcome from a full-time functional restoration program with the outcome from shorter active rehabilitation programs for patients with chronic, disabling low back pain. The study initially included 132 patients, randomized into one of three treatment programs: (1) an intensive 3-week multidisciplinary program; (2) active physical training and back school; or (3) psychological pain management and active physical training. Nine of the randomized patients never started in any program, so the studied population consisted of 123 patients. Of these, 14 patients (11%) dropped out. The results presented here are at 1 year following treatment, where we achieved a 92% response rate, including the drop-outs. The functional restoration program was superior to the shorter programs as to work-ready rate, health care contacts, back pain level, disability level, staying physically active, and reduction in analgesics. There was no significant difference between Programs 2 and 3 in most of these parameters. As for sick leave and leg pain, there was no significant difference between Programs 1 and 2, although a difference was observed when comparing Program 3 with each of the other two. Conclusively, it seems that there is human, as well as economical, benefit from a functional restoration program compared to less intensive programs for these patients.