Mini-intervention for subacute low back pain -: A randomized controlled trial

Study Design. Randomized controlled trial. Objectives. To investigate the effectiveness and costs of a mini-intervention, provided in addition to the usual care, and the incremental effect of a work site visit for patients with subacute disabling low back pain. Summary of Background Data. There is lack of data on cost-effectiveness of brief interventions for patients with prolonged low back pain. Methods. A total of 164 patients with subacute low back pain were randomized to a mini-intervention group ( A), a work site visit group ( B), or a usual care group ( C). Groups A (n = 56) and B ( n = 51) underwent one assessment by a physician plus a physiotherapist. Group B received a work site visit in addition. Group C served as controls ( n = 57) and was treated in municipal primary health care. All patients received a leaflet on back pain. Pain, disability, specific and generic health-related quality of life, satisfaction with care, days on sick leave, and use and costs of health care consumption were measured at 3-, 6-, and 12-month follow-ups. Results. During follow-up, fewer subjects had daily pain in Groups A and B than in Group C ( Group A vs. Group C, P = 0.002; Group B vs. Group C, P = 0.030). In Group A, pain was less bothersome ( Group A vs. Group C, P = 0.032) and interfered less with daily life ( Group A vs. Group C, P = 0.040) than among controls. Average days on sick leave were 19 in Group A, 28 in Group B, and 41 in Group C ( Group A vs. Group C, P = 0.019). Treatment satisfaction was better in the intervention groups than among the controls, and costs were lowest in the mini-intervention group. Conclusions. Mini-intervention reduced daily back pain symptoms and sickness absence, improved adaptation to pain and patient satisfaction among patients with subacute low back pain, without increasing health care costs. A work site visit did not increase effectiveness.