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A cost-effective program to prevent back pain at work

A cost-effective program to prevent back pain at work

A clinical trial tests the efficacy of an innovative program to prevent musculoskeletal disorders done on the workplace.

A Swedish randomized controlled trial of Linton and colleagues, published in the Journal of Occupational Rehabilitation in 2015, assesses the efficacy of one month intervention based on learning and communication strategies to prevent problem resolution Chronic musculoskeletal pain of workers. This non-drug intervention is implemented with workers and their employers. The results show an improvement in perceived health and fewer days off work-related musculoskeletal pain for the group benefiting from the innovative intervention compared to the control group.


The Study Rationale

Musculoskeletal disorders such as back pain or neck are common health problems in the workplace. They prove costly for the health system. Involved, inadequate working postures, repetitive movements, sitting too long a station. The principles are known to avoid them, and yet, more and more workers suffer from back pain or neck.

It is necessary to develop effective and appropriate methods to prevent these pains. This study offers an innovative non-drug intervention based on two complementary theories, the problem-solving model based on targeted cognitive-behavioral strategies and removal of dysfunctional thoughts. This second model aims to decrease the state of hypervigilance workers anticipating a potential sign of pain. This generates a feeling inadequate anticipation of concern. Over time, this concern is a source of fatigue, psychological distress and disability.

Most psychosocial interventions for prevention cater exclusively to people concerned. Recent studies calling for the integration spouses, family members, co-workers and / or employers in these primary prevention.

The article invites to think that acting on the workplace could prove very useful to prevent musculoskeletal disorders of those at risk.

A prevention of musculoskeletal disorders in the workplace reduce the number of disability.

The Question

Preventive action seeking both workers and their work environment and using communication strategies and problem solving is it effective in preventing musculoskeletal disorders?

The Method

The randomized controlled trial of Linton and colleagues, published in the Journal of Occupational Rehabilitation in 2015, evaluates the effectiveness of primary prevention work conducted with workers and their employers to prevent disability due to musculoskeletal disorders -skeletal. This interventional program is compared to a usual care. 140 people of 27-65 years participated in this study. They were suffering from back pain with a higher risk of developing a chronic musculoskeletal disorder.

The researchers evaluated the days off work-related musculoskeletal disorders, the use of care, perceived health and pain intensity. Measurements were made before and after the intervention, and six months after surgery. Interventions and data collection was made in a Swedish health care center.

The Non-Pharmacological Intervention (NPI) assessed

The patients in the experimental group received a brief psychological intervention based on the principles of cognitive-behavioral therapies. Participants were followed by four clinical psychologists for three sessions. Each session lasted 60 to 90 minutes.

The main objective of the intervention was for workers to increase their ability to self-manage daily and especially on their workplace, obstacles related to their experience of pain.

Workers participating in three consecutive sessions:
– The first was to analyze the problems and define specific objectives. This session allowed to reframe the definition of the pain problem as a major issue to be resolved in order to reach long-term goals.
– The second was to develop problem-solving skills to achieve desired goals.
– The third was to establish effective communication in the workplace. This session allowed to develop communication skills based on experience, emotion and expression of needs related pain.

The main objective was to limit employers psychosocial risk factors at work in order to prevent the onset of chronic pain in their employees. They also took part in three consecutive sessions:
– The first was to analyze the problem and develop skills to solve it.
– The second was to develop effective communication.
– The third was monitoring of strategies put in place.

Main Results

Analysis of the results shows a decrease from the average of two days of work stoppage 6 months after the intervention (38 instead of 17 days). The difference is statistically significant compared to the control group at six months. The researchers also note an improvement in perceived health and a decrease in the use of care for the intervention group compared with the control group. The intensity of the pain is reduced identically in both groups.

The intervention tested provides evidence that primary preventive action one month addressed jointly to employees and employers to improve the perceived health of employees, reduces the intensity of back pain while decreasing the number of work stoppages and care of the requests.


What it means for Patients

A program of one month for primary prevention based learning problem-solving and communication strategies involving employees and employers improves perceived health of employees, reduces the intensity of their back pain and reduces the demand for care.

What it means for Healthcare Professionals

An intervention in primary prevention targeted to workers suffering from musculoskeletal disorders, involving workers and employers, and based on learning and communication problems solving strategies improves the perceived health of employees, reduces the intensity of their back pain while halving the number of days off work and reducing their care demands.

What it means for Researchers

This randomized controlled trial shows that a targeted intervention in primary prevention of musculoskeletal disorders and learning-based communication strategies and solve problems jointly addressed to workers and their employers is effective and cost / effective to improve health and reduce absenteeism from work. Further studies should be conducted with cost-utility analysis and cost-effectiveness.

What it means for Policymakers

An intervention in primary prevention involving employees and their employers, focused on prevention of musculoskeletal disorders and based on learning and communication problems solving strategies improves the perceived health of employees, reduced pain intensity lumbar while halving the number of days off work and reducing care requirements. The development of this type of targeted intervention, concerted and rational would improve the health of employees, reduce absenteeism and prevent health spending.


The Reference

Linton SJ, Boersma K, Traczyk M, Shaw W, Nicholas M (2015). Early workplace communication and problem solving to prevent back disability: Results of a randomized controlled trial among high-risk workers and their supervisors. Journal of Occupational Rehabilitation, 23, 1-10.


Related articles on Blog en Sante ©

Same topic

Same population

Same non-pharmacological intervention


To reference this Blog en Sante © article

Ninot G (2015). A cost-effective program to prevent back pain at work. Blog en Sante, A71.

© Copyright 2015 Gregory Ninot. All rights reserved.

One thought on “A cost-effective program to prevent back pain at work
  1. Nicolas says:

    Article très intéressant.

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