Effectiveness of a multidisciplinary rehabilitation program in real-world patients with chronic back pain: A pilot cohort data analysis

J Back Musculoskelet Rehabil. 2021;34(6):965-973. doi: 10.3233/BMR-200305.


Background: Randomized clinical trials (RCT) suggest a multidisciplinary approach to pain rehabilitation is superior to other active treatments in improving pain intensity, function, disability, and pain interference for patients with chronic pain, with small effect size (ds= 0.20-0.36) but its effectiveness remains unknown in real-world practice.

Objective: The current study examined the effectiveness of a multidisciplinary program to a cognitive and behavioral therapy (pain-CBT) in real-world patients with chronic back pain.

Methods: Twenty-eight patients (M𝑎𝑔𝑒= 57.6, 82.1% Female) completed a multidisciplinary program that included pain psychology and physical therapy. Eighteen patients (M𝑎𝑔𝑒= 58.9, 77.8% Female) completed a CBT-alone program. Using a learning healthcare system, the Pain Catastrophizing Scale, 0-10 Numerical Pain Rating Scale, and Patient-Reported Outcomes Measurement Information System® measures were administered before and after the programs.

Results: We found significant improvement in mobility and pain behavior only after a multidisciplinary program (p's < 0.031; d= 0.69 and 0.55). We also found significant improvement in pain interference, fatigue, depression, anxiety, social role satisfaction, and pain catastrophizing after pain-CBT or multidisciplinary programs (p's < 0.037; ds = 0.29-0.73). Pain ratings were not significantly changed by either program (p's > 0.207).

Conclusions: The effect of a multidisciplinary rehabilitation program observed in RCT would be generalizable to real-world practice.

Keywords: Chronic back pain; a learning health system; acceptance and commitment therapy; cognitive and behavioral therapy; multidisciplinary program; physical therapy.

MeSH terms

  • Back Pain / therapy
  • Catastrophization
  • Chronic Pain* / therapy
  • Data Analysis*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain Management
  • Treatment Outcome