Intensive therapy improves low back pain, but is it worth the cost?

Multidisciplinary rehabilitation for chronic low back pain: systematic review

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Intensive rehabilitation programmes reduce pain and improve function in patients with chronic low back pain, concludes a study in this week's BMJ, but it remains unclear whether the improvements are worth the cost of these intensive treatments.

Disabling low back pain is thought to be a result of interrelating physical, psychological, and social or occupational factors requiring multidisciplinary treatment. The research team reviewed 10 trials, involving nearly 2,000 adults with low back pain, to assess the impact of such multidisciplinary treatment approaches.

The reviewed studies provided evidence that intensive multidisciplinary treatment produces greater improvements in pain and function for patients with disabling chronic low back pain than less intensive multidisciplinary programmes, non-multidisciplinary rehabilitation or usual care.

However, these intensive programmes might have a large impact on healthcare resources, say the authors, and it is not clear whether the benefits outweigh the costs. The final judgement will depend on societal resources, available alternatives, and the value attached to reducing human suffering from back pain, they conclude.

Contact:

Jaime Guzman, Research Associate, University of Manitoba Faculty of Medicine, Winnipeg, Canada

Tel: 1-204-789-3457
Email: guzmanjo@cc.umanitoba.ca