Evaluation of effective return-to-work treatment programs for sick-listed patients with non-specific musculoskeletal complaints: a systematic review

Objective: This systematic review seeks to gain insight into the effectiveness of return-to-work treatment programs among sick-listed patients with non-specific musculoskeletal complaints. The focus here lies on the composition of effective treatment programs, itemized for regional non-specific musculoskeletal complaints. Methods: A systematic literature search was performed and methodological quality criteria were applied. Results: Eighteen high quality articles were selected, which reported on a combined total of 22 treatment programs, including a total of 3,579 participants. Of these 22 treatments programs, seven experimental treatments (32%) resulted in faster return to work compared to the control treatment. None of the studies reviewed reported negative findings. What appeared to be essential to effective treatment was knowledge conditioning, psychological, physical and work conditioning, possibly supplemented with relaxation exercises. Most of the high quality studies (64%) reported on a low back pain population. Conclusion: The findings were inconsistent regarding the effectiveness of treatment programs in enabling sick-listed patients with non-specific musculoskeletal disorders to return to work. Except for low back pain, none of the studies explicitly itemized the effects of treatment programs on return to work by regional musculoskeletal disorders, such as upper extremity musculoskeletal disorders.