Abstract
BackgroundLow back pain is prevalent and is a frequent cause of disability and sick leave among working adults. Individuals with low back pain often consult general practice or other health care providers which often results in a unilateral intervention focussed on their symptoms. Employment is associated with physical and mental well-being, so, patients may benefit from an early additional occupational medicine intervention. For individuals with physically demanding jobs it can be especially challenging to retain their jobs. The aim of the ‘GoBack trial' is to develop and evaluate the efficacy and feasibility of an occupational medicine intervention for individuals with low back pain in physically demanding jobs.Methods/designWe will conduct a randomised controlled trial enrolling 300 participants with difficulty in maintaining physically demanding jobs due to low back pain for a current period of 2 to 4 weeks. Participants will be randomised and stratified according to their age and gender before being allocated in a 1:1 ratio to either control or additional occupational medicine intervention. Both groups will receive conventional treatment for their low back pain during the study. All participants will be thoroughly assessed for causes of low back pain and potential prognostic factors by questionnaires, clinical specialist assessments and magnetic resonance imaging (MRI) scans of the lumbar spine. Primary outcome is the accumulated duration of self-assessed sick leave (in days) due to low back pain during 6 months from baseline. Secondary outcomes include general self-rated back pain, disability and screening for potential prognostic factors: fear avoidance behaviour, disability, health status and degenerative MRI findings. For tertiary purposes selected outcomes will also be assessed after 1 and 2 years from baseline.DiscussionMany guidelines exist for the management of low back pain, but they provide limited guidance on occupational aspects. The findings from this randomised trial will provide high-quality evidence for the efficacy and feasibility of an occupational medicine intervention model for individuals with low back pain in physically demanding jobs.Trial registrationThis trial was registered with ClinicalTrials.gov (identifier: NCT02015572) on 29 November 2013.
Highlights
Low back pain is prevalent and is a frequent cause of disability and sick leave among working adults
Many guidelines exist for the management of low back pain, but they provide limited guidance on occupational aspects
Low back pain (LBP) is a common reason for doctor visits and is a significant cause of sick leave and disability pension with huge personal and socioeconomic consequences [2]
Summary
Low back pain is prevalent and is a frequent cause of disability and sick leave among working adults. Individuals with low back pain often consult general practice or other health care providers which often results in a unilateral intervention focussed on their symptoms. Employment is associated with physical and mental well-being, so, patients may benefit from an early additional occupational medicine intervention. The aim of the ‘GoBack trial' is to develop and evaluate the efficacy and feasibility of an occupational medicine intervention for individuals with low back pain in physically demanding jobs. It has been demonstrated that over 60% of LBP patients from general practice may experience more than three episodes of pain after their first episode [5]. Despite a large heterogeneity in LBP conditions, the overall picture is clearly that LBP is not a self-limiting condition [5,8,9]; return to work or work retention seems to be a good outcome measurement for LBP interventions
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