Early Intervention Options for Acute Low Back Pain Patients: A Prospective One-Year Follow-Up Study
Whitfill, Travis A.
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This study represents a continuation of research that has focused on the treatment of acute low back pain (ALBP) patients using techniques designed to address the psychosocial, as well as physical, aspects of pain. Initially, an algorithm was developed by Gatchel et al. (1995a) to identify patients suffering from ALBP who were at high-risk for developing chronic low back pain (CLBP). An interdisciplinary early intervention program was then implemented by Gatchel et al. (2003) to discourage the progression of ALBP to CLBP. Previous studies demonstrated the effectiveness of the early intervention program in reducing levels of pain and disability as compared to those not receiving additional treatment. Another advantage that the treatment group had, relative to the "treatment as usual" group, was cost-effectiveness, as evidenced by lower levels of healthcare utilization, time away from work and medication costs. Due to the important position that work status holds in a discussion of disability and costs associated with injury, a work transition component was added to the early intervention program. Individuals considered high-risk for developing LBP were randomly assigned into one of four groups: early intervention (EI); early intervention with work transition (EI/WT); work transition (NI/W); and non-intervention (NI). A one-year prospective study looked at how these groups differed regarding outcome measures designed to evaluate pain level, coping abilities and work status (Holberg&Gatchel, 2007). Earlier findings were confirmed regarding the effectiveness of early intervention programs at addressing these issues, but a small sample size did not allow for conclusive results. The current study expanded upon previous research by utilizing additional instruments in the measurement of the physical and psychosocial status of those at high risk for developing CLBP, including cortisol analyses intended to demonstrate the interplay between the physical and mental aspects of pain. In addition to these measures, an increase in sample size allowed for greater statistical power and more definitive statements regarding the long-term efficacy of early intervention interdisciplinary programs for the treatment of ALBP.