Integrated Care More Cost-Effective for Low Back Pain

Low back pain can have a detrimental impact on productivity in the workplace, and for many patients, ineffective treatment can slow down recovery and further prolong a person's return to work after an injury. Two recent studies investigate ways that employers and health care professionals can assist in a patient's recovery.

A study in the UK looked at how patients with low back pain modify their work environments to reduce absences and disability. Interviews with 25 workers suffering from low back pain revealed that although many attempt to make changes in their workplace to accommodate their injury, they often encounter insufficient support and expertise among their managers for creating these adjustments. Modifications are often made informally, rather than coordinated with an occupational health department within the company. This lack of support can result in a slower return to pre-injury productivity levels, and in some cases lead patients to leave the workplace altogether.

A second study, this one a controlled trial published in the British Medical Journal, found that for patients with chronic low back pain, a treatment plan that incorporated integrated care was most cost-effective when compared with standard clinical procedures.

The researchers for this study assigned 134 patients to one of two treatment groups. Patients who received integrated care worked with an occupational physician and a team of healthcare professionals, including a manual therapist, and coordinated with the patient's supervisor at work to collectively plot a treatment plan that incorporated workplace adaptations, ergonomics, behavioral approaches, and a gradual return to work. Patients in the control group received standard treatment through their general practitioner.

At the end of the treatment, the total cost of traditional treatment was significantly higher, both to the individual and to society in the loss of productivity, when compared to the more cost-effective integrated treatment. These results confirm that taking an integrated approach to the treatment of low back pain can result in lower costs and a faster return to work.

Chiropractic is an important aspect of integrated treatment, offering a noninvasive alternative to pain medication that has been proven effective for many people suffering from low back pain. As these studies show, it can also be a cost-effective solution that promotes a quicker return to overall health. Crafting a treatment plan that considers a patient's life and workplace needs is increasingly being shown to be an important key to recovery.

Coole C, Watson PJ, Drummond A. Low back pain patients' experiences of work modifications; a qualitative study. BMC Musculoskeletal Disorders 2010, 11:277

Lambeek LC, Bosmans JE, van Royen BJ, van Tulder MW, van Mechelen W, Anema JR. Effect of integrated care for sick listed patients with chronic low back pain: economic evaluation alongside a randomised controlled trial. British Medical Journal. 2010; 341:c6414.