Effects of an early multidisciplinary intervention on sickness absence in patients with persistent low back pain - a randomized controlled trial

Background: Multidisciplinary rehabilitation is recommended to reduce sickness absence and disability in patients with subacute or chronic LBP. This RCT aimed to investigate whether a 12-week coordinated work oriented multidisciplinary rehabilitation intervention was effective on return to work and number of days off work during one-year follow-up when compared to usual care. Methods: This study is a randomized controlled trial comparing a 12-week multidisciplinary vocational rehabilitation program with usual treatment. 770 patients with LBP, who were sick-listed, or at risk of being sick-listed were included in the study. The primary outcome was number of days off work due to LBP. The secondary outcomes were disability, health-related quality of life, pain, psychological distress and fear avoidance behavior.Data were collected at baseline, at the end of treatment, and at 6- and 12-months follow-up. Analyses were carried out according to the “intention-to-treat” principles. Results: A significant decrease in the number of days off work was found in both groups at the end of treatment and at 6- and 12-months follow-up. Additionally, disability, pain, health related quality of life, psychological distress, and fear avoidance beliefs improved in both groups. No statistically significant differences were found between the groups on any of the outcomes. Conclusions: The coordinated multidisciplinary intervention had no additional effect on sickness absence, disability, pain, or health related quality of life as compared with that of usual care. Trial registration This study was registered in ClinicalTrials.gov (registration ID: NCT01690234). The study was approved by The Danish Regional Ethics Committee (file no: H-C-2008-112) as well as registered at and approved by the Danish Data Protection Agency.