Individual active treatment combined with group exercise for acute and subacute low back pain.
STUDY DESIGN
Randomized controlled trial.


OBJECTIVE
To compare two fast-access evidence-based interventions for the treatment of simple low back pain.


SUBJECTS
People aged 18-65 with a new episode of simple back pain causing them to be off work or on modified work for less than 1 year.


SETTING
A district general hospital using a consultation/treatment room and a rehabilitation gym.


METHODS
One group received a back advice booklet and one session of advice and then followed the normal route of care as directed by their general practitioner. The other group received the back booklet and one session of advice and also a back program. The back program consisted of a full assessment, immediately followed by one individual treatment, and then exercise classes over 1 to 2 weeks.


OUTCOME MEASURES
(1) Rate of return to work, (2) pain scores and health status, and (3) cost effectiveness of interventions versus the financial cost to the individual or employer.


RESULTS
On average, those receiving the individual treatment and group exercise took 7 days less off work. This represented a 35% reduction in the amount of time taken off work since study entry. The estimated cost saving of providing the extra service of a simple back program ranged between 250 pound (367 US dollars, 300 euro) and 578 pound (850 US dollars, 694 euro) for each patient.


CONCLUSION
The results indicate that the costs of this active back program are more than reimbursed as a consequence of earlier return to work.