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Early Intervention Options for Acute Low Back Pain Patients: A Randomized Clinical Trial with One-Year Follow-Up Outcomes

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Abstract

Introduction In an earlier study, Gatchel et al. (J Occup Rehabil 13:1–9, 2003) demonstrated that participants at high risk for developing chronic low back pain disability (CLBPD), who received a biopsychosocial early intervention treatment program, displayed significantly more symptom improvement, as well as cost savings, relative to participants receiving standard care. The purpose of the present study was to expand on these results by examining whether the addition of a work-transition component would further strengthen the effectiveness of this early intervention treatment. Methods Using an existing algorithm, participants were identified as being high-risk (HR) or low-risk (LR) for developing CLBPD. HR participants were then randomly assigned to one of three groups: early intervention (EI); early intervention with work transition (EI/WT); or standard care (SC). Participants provided information regarding pain, disability, work status, and psychosocial functioning at baseline, periodically during treatment, and again 1 year following completion of treatment. Results At 1-year follow-up, no significant differences were found between the EI and EI/WT groups in terms of occupational status, self-reports of pain and disability, coping ability or psychosocial functioning. However, significant differences in all these outcomes were found comparing these groups to standard care. Conclusion The addition of a work transition component to an early intervention program for the treatment of ALBP did not significantly contribute to improved work outcomes. However, results further support the effectiveness of early intervention for high-risk ALBP patients.

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Authors and Affiliations

  1. Division of Clinical Psychology, The University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA

    Travis Whitfill

  2. Department of Psychology, College of Science, The University of Texas at Arlington, Arlington, TX, 76019, USA

    Robbie Haggard & Robert J. Gatchel

  3. Department of Physical Medicine & Rehabilitation, The University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA

    Samuel M. Bierner

  4. Liberty Mutual Research Center, Hopkinton, MA, USA

    Glenn Pransky

  5. VP Medical Operations, Concentra Health Services, Addison, TX, USA

    Robert G. Hassett

Authors
  1. Travis Whitfill
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  2. Robbie Haggard
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  3. Samuel M. Bierner
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  4. Glenn Pransky
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  5. Robert G. Hassett
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  6. Robert J. Gatchel
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Corresponding author

Correspondence to Robert J. Gatchel.

Additional information

The writing of this article was supported in part by grants to Dr. Gatchel from the National Institutes of Health (3R01 MH 046452, 1K05 MH 071892).

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Whitfill, T., Haggard, R., Bierner, S.M. et al. Early Intervention Options for Acute Low Back Pain Patients: A Randomized Clinical Trial with One-Year Follow-Up Outcomes. J Occup Rehabil 20, 256–263 (2010). https://doi.org/10.1007/s10926-010-9238-4

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  • DOI: https://doi.org/10.1007/s10926-010-9238-4

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