Mini-intervention for subacute low back pain: a randomized controlled trial

Spine (Phila Pa 1976). 2003 Mar 15;28(6):533-40; discussion 540-1. doi: 10.1097/01.BRS.0000049928.52520.69.


Study design: Randomized controlled trial.

Objectives: To investigate the effectiveness and costs of a mini-intervention, provided in addition to the usual care, and the incremental effect of a work site visit for patients with subacute disabling low back pain.

Summary of background data: There is lack of data on cost-effectiveness of brief interventions for patients with prolonged low back pain.

Methods: A total of 164 patients with subacute low back pain were randomized to a mini-intervention group (A), a work site visit group (B), or a usual care group (C). Groups A (n = 56) and B (n = 51) underwent one assessment by a physician plus a physiotherapist. Group B received a work site visit in addition. Group C served as controls (n = 57) and was treated in municipal primary health care. All patients received a leaflet on back pain. Pain, disability, specific and generic health-related quality of life, satisfaction with care, days on sick leave, and use and costs of health care consumption were measured at 3-, 6-, and 12-month follow-ups.

Results: During follow-up, fewer subjects had daily pain in Groups A and B than in Group C (Group A Group C, = 0.002; Group B Group C, = 0.030). In Group A, pain was less bothersome (Group A Group C, = 0.032) and interfered less with daily life (Group A Group C, = 0.040) than among controls. Average days on sick leave were 19 in Group A, 28 in Group B, and 41 in Group C (Group A Group C, = 0.019). Treatment satisfaction was better in the intervention groups than among the controls, and costs were lowest in the mini-intervention group.

Conclusions: Mini-intervention reduced daily back pain symptoms and sickness absence, improved adaptation to pain and patient satisfaction among patients with subacute low back pain, without increasing health care costs. A work site visit did not increase effectiveness.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adult
  • Disability Evaluation
  • Exercise
  • Female
  • Finland
  • Follow-Up Studies
  • Health Care Costs / statistics & numerical data
  • Humans
  • Low Back Pain / economics
  • Low Back Pain / therapy*
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care / economics
  • Outcome Assessment, Health Care / statistics & numerical data*
  • Pain Measurement / statistics & numerical data
  • Patient Satisfaction / statistics & numerical data
  • Physical Therapy Modalities
  • Quality of Life
  • Sick Leave / statistics & numerical data
  • Workplace