A 10-year follow-up of tailored behavioural treatment and exercise-based physiotherapy for persistent musculoskeletal pain

Clin Rehabil. 2017 Feb;31(2):186-196. doi: 10.1177/0269215516639356. Epub 2016 Jul 10.


Objective: To study the long-term outcomes of two interventions targeting patients with sub-acute and persistent pain in a primary care physiotherapy setting.

Design: A 10-year follow-up of a two-armed randomised controlled trial, initially including 97 participants.

Interventions: Tailored behavioural medicine treatment, applied in a physiotherapy context (experimental condition), and exercise-based physiotherapy (control condition).

Main measures: Pain-related disability was the primary outcome. The maximum pain intensity, pain control, fear of movement, sickness-related absence (register data) and perceived benefit and confidence in coping with future pain problems were the secondary outcomes.

Results: Forty-three (44%) participants responded to the follow-up survey, 20 in the tailored behavioural medicine treatment group and 23 in the exercise-based physiotherapy group. The groups did not differ in terms of the change in the scores for the primary outcome ( p=0.17) of pain-related disability between the experimental group (median: 2.5, Q1-Q3: -2.5-14.25), and the control group (median: 0, Q1-Q3: -5-6). Further, there were also no significant differences found for the secondary outcomes except for sickness-related absence, where the exercise-based physiotherapy group had more days of sickness-related absence three months before treatment ( p= 0.02), and at the 10-year follow-up ( p=0.03).

Discussion: The beneficial effects favouring tailored behavioural medicine treatment that observed post-treatment and at the two-year follow-up were not maintained 10 years after treatment.

Keywords: Chronic pain; behavioural medicine; long-term compliance; physical exercise; primary care.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Behavior Therapy / methods*
  • Combined Modality Therapy
  • Disability Evaluation*
  • Exercise Therapy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Musculoskeletal Pain / diagnosis*
  • Musculoskeletal Pain / rehabilitation*
  • Pain Measurement
  • Physical Therapy Modalities
  • Risk Assessment
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Time Factors
  • Treatment Outcome