Benefits of Low Back Pain Program Persist

One year after starting a self-management program for low back pain, patients still retain early improvements in function, confidence and reduced depression and anxiety levels, investigators report in the Archives of Internal Medicine.

Dr. Teresa M. Damush, at the Indiana University School of Medicine in Indianapolis, and her team conducted a program that included classes focusing on treatment recommendations, behavioral changes, increasing self-confidence and reducing symptoms of depression and anxiety. Follow-up telephone calls were made once or twice per month.

The subjects were inner-city primary care patients with low back pain. "This was a very low-income population," Damush told Reuters Health. "Such patients often report a lot of low back pain, which could be related to the type of jobs they're employed in or increased stress."

Sixty-three patients assigned to the active intervention and 76 assigned to usual care completed 12-month interviews.

Significant improvements in symptoms, psychological symptoms, and physical functioning that were achieved after four months in the intervention group were maintained at one year. Overall physical functioning improved significantly compared with the control group between four and 12 months.

Improvements in functioning specifically related to lower back pain were clearly seen, Damush said. "They reported less pain, and less interference with daily activities, such as difficulty turning over in bed or need to use a handrail when climbing stairs."

"Many of these patients thought that they should take it easy and get more rest," she added. "They were afraid that physical activity might trigger another episode."

According to her group's report, decreases in fear and avoidance of activity accompanied the other improvements. The active treatment group also spent significantly more time engaged in physical activity.

Damush and colleagues are now conducting a study to examine the cost-effectiveness of the program and associated changes in health care utilization.

SOURCE: Archives of Internal Medicine, November 24, 2003.

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