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October/November 2015 (vol. 12/3)
Combination approach to back pain
A brief intervention, combining problem solving for individual workers and training on communication for supervisors, reduced sickness absence and improved perceived health in workers with back pain compared with evidence-based treatment as usual (TAU), according to this randomised controlled trial involving 140 workers and 55 supervisors. Workers were put in the intervention or TAU group according to the random allocation of their supervisors (this ensured that no supervisor managed workers in both groups). Supervisors in the intervention group received communication training aimed at providing a supportive work environment and reducing psychosocial risk factors. Using cognitive-behavioural principles the worker training aimed to improve selfmanagement of work-related obstacles related to pain experience. At the six-month follow-up, both treatments reduced the number of absences due to pain over the previous three months; however, the incidence was more than halved in the intervention group, and the difference was statistically significant. Risk of absence was 2.4-times higher in the TAU group compared with the intervention group (odds ratio (OR) = 2.44; 95% confidence interval (CI) 1.10–5.43; p < 0.05). The amount of absence was also higher in the TAU group (mean absence 15.4 days over three months) compared with the intervention (4.1 days; p = 0.028). The intervention group also had lower use of healthcare and improved perceived health. There were no significant differences in pain intensity ratings. The researchers estimate a rough cost–benefit ratio of 1:1.7.
Occupational Health at Work October/November 2015 (vol. 12/3) pp33