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Multidisciplinary Approach to Back Pain
Combining physical, psychological, and/or social/work interventions may help reduce pain and disability in patients with chronic low back pain.

It can be expensive, but multidisciplinary rehabilitation may be more cost-effective for treating chronic low back pain in the long-term, according to researchers from the University of Sydney in Australia; VU University Medical Centre in Amsterdam and Maastricht University Medical Centre, both in the Netherlands; and University of British Columbia in Vancouver, Canada. After analyzing 41 trials comparing a variety of biopsychosocial interventions with usual care and physical treatment, researchers found benefits in reduced pain and disability and a greater likelihood of returning to work (odds ratio 1.04, .73-1.47) that lasted beyond 1 year.

Related: Establishing and Evaluating an Acupuncture Clinic in a VA Medical Center

The multidisciplinary approach involved a physical component and a psychological component and/or a social/work-targeted component. The interventions were of any intensity and rehabilitation approach and could be provided in inpatient or outpatient settings. The control interventions were classified as usual care, physical treatment, surgery, and waiting list.

The researchers found moderate-quality evidence that multidisciplinary rehabilitation programs are more effective than is usual care (95% confidence interval, .04-.37) for reducing pain and disability from chronic low back pain. They also found no difference between the effects of surgery compared with multidisciplinary treatment on pain (standardized mean difference [SMD] .72, 0.24-1.22); disability (SMD .49, 0.22-0.76); and work (SMD .67, 0.31-1.45). The researchers also noted that surgery comes with a greater risk of adverse events.

Related: Development of a Multidisciplinary Stroke Program

The modest results should be weighed against the monetary costs and time commitments associated with multidisciplinary rehabilitation, the researchers caution. They suggest referring only those patients for whom low back pain has major physical and psychological effects.

Source
Kamper SJ, Apeldoorn AT, Chiarotto A, et al. BMJ. 2015;350:h444.
doi: 10.1136/bmj.h444.

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physical rehabilitation, multidisciplinary rehabilitation, chronic low back pain, biopsychosocial interventions, physical effects of pain, psychological effects of pain, pain treatment, physical rehabilitation
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Combining physical, psychological, and/or social/work interventions may help reduce pain and disability in patients with chronic low back pain.
Combining physical, psychological, and/or social/work interventions may help reduce pain and disability in patients with chronic low back pain.

It can be expensive, but multidisciplinary rehabilitation may be more cost-effective for treating chronic low back pain in the long-term, according to researchers from the University of Sydney in Australia; VU University Medical Centre in Amsterdam and Maastricht University Medical Centre, both in the Netherlands; and University of British Columbia in Vancouver, Canada. After analyzing 41 trials comparing a variety of biopsychosocial interventions with usual care and physical treatment, researchers found benefits in reduced pain and disability and a greater likelihood of returning to work (odds ratio 1.04, .73-1.47) that lasted beyond 1 year.

Related: Establishing and Evaluating an Acupuncture Clinic in a VA Medical Center

The multidisciplinary approach involved a physical component and a psychological component and/or a social/work-targeted component. The interventions were of any intensity and rehabilitation approach and could be provided in inpatient or outpatient settings. The control interventions were classified as usual care, physical treatment, surgery, and waiting list.

The researchers found moderate-quality evidence that multidisciplinary rehabilitation programs are more effective than is usual care (95% confidence interval, .04-.37) for reducing pain and disability from chronic low back pain. They also found no difference between the effects of surgery compared with multidisciplinary treatment on pain (standardized mean difference [SMD] .72, 0.24-1.22); disability (SMD .49, 0.22-0.76); and work (SMD .67, 0.31-1.45). The researchers also noted that surgery comes with a greater risk of adverse events.

Related: Development of a Multidisciplinary Stroke Program

The modest results should be weighed against the monetary costs and time commitments associated with multidisciplinary rehabilitation, the researchers caution. They suggest referring only those patients for whom low back pain has major physical and psychological effects.

Source
Kamper SJ, Apeldoorn AT, Chiarotto A, et al. BMJ. 2015;350:h444.
doi: 10.1136/bmj.h444.

It can be expensive, but multidisciplinary rehabilitation may be more cost-effective for treating chronic low back pain in the long-term, according to researchers from the University of Sydney in Australia; VU University Medical Centre in Amsterdam and Maastricht University Medical Centre, both in the Netherlands; and University of British Columbia in Vancouver, Canada. After analyzing 41 trials comparing a variety of biopsychosocial interventions with usual care and physical treatment, researchers found benefits in reduced pain and disability and a greater likelihood of returning to work (odds ratio 1.04, .73-1.47) that lasted beyond 1 year.

Related: Establishing and Evaluating an Acupuncture Clinic in a VA Medical Center

The multidisciplinary approach involved a physical component and a psychological component and/or a social/work-targeted component. The interventions were of any intensity and rehabilitation approach and could be provided in inpatient or outpatient settings. The control interventions were classified as usual care, physical treatment, surgery, and waiting list.

The researchers found moderate-quality evidence that multidisciplinary rehabilitation programs are more effective than is usual care (95% confidence interval, .04-.37) for reducing pain and disability from chronic low back pain. They also found no difference between the effects of surgery compared with multidisciplinary treatment on pain (standardized mean difference [SMD] .72, 0.24-1.22); disability (SMD .49, 0.22-0.76); and work (SMD .67, 0.31-1.45). The researchers also noted that surgery comes with a greater risk of adverse events.

Related: Development of a Multidisciplinary Stroke Program

The modest results should be weighed against the monetary costs and time commitments associated with multidisciplinary rehabilitation, the researchers caution. They suggest referring only those patients for whom low back pain has major physical and psychological effects.

Source
Kamper SJ, Apeldoorn AT, Chiarotto A, et al. BMJ. 2015;350:h444.
doi: 10.1136/bmj.h444.

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Federal Practitioner - 32(4)
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Federal Practitioner - 32(4)
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Multidisciplinary Approach to Back Pain
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Multidisciplinary Approach to Back Pain
Legacy Keywords
physical rehabilitation, multidisciplinary rehabilitation, chronic low back pain, biopsychosocial interventions, physical effects of pain, psychological effects of pain, pain treatment, physical rehabilitation
Legacy Keywords
physical rehabilitation, multidisciplinary rehabilitation, chronic low back pain, biopsychosocial interventions, physical effects of pain, psychological effects of pain, pain treatment, physical rehabilitation
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