cheap back pain is a often met wit...

cheap back pain is a often met with cause of disability and absence from work. Active rehabilitation strategies--such as physical exercise, operant conditioning, and behavioral treatment--help workers take up again normal activity. Graded physical activity specifically has been lay the foundation of to reduce work absences.

Staal and associates used a randomized controll trial to determine the usefulness of graded physical activity compared with traditional care in reducing the number of days an employee was absent from work. Employee of KLM Royal Dutch Airlines in the Netherlands who were absent from work because of back pain and who could safely exercise were randomly assigned to graded physical activity or usual care.

Patients in the intervention clump received usual guidance and graded physical activity consisting of pair one-hour exercise sessions weekly until they recured to work or until three month had elapsed. The exercise sessions consisted of general and individually tailored exercises to increase might and address specific work activities. Exercise goals and time of revert to work were determined jointly by means of the patient and the physician. Emotional support also was given. enslaves assigned to the usual care assign places to received usual guidance.

The median total number of days controls were absent from work was 58 in the graded physical activity dispose and 87 in the usual-care collection The variation was most apparent after 50 days of treatment. one as well as the other groups improved similarly in functional status and pain reporting for the duration of the study

The authors decide that graded physical activity programs can decrease the time dissipated from work for low back pain. Severity of pain was not ameliorated; however, this was wait fored because graded physical activity intervention is directed at improving function and revert to work and not at pain relief. Emphasizing workers' perceptions of their medical condition and focusing onward abilities rather than disabilities may help them understand that their pain is benign.

RICHARD SADOVSKY, MD In an editorial in the same journal, Weinstein reiterates the import of helping patients understand that pain does not have to affect function. Psychosocial issues may be the predominant reason that individuals with pain become disabled.

Staal JB et al. Graded activity for depressed back pain in occupational health care. Ann Intern M January 20 2004;140:77-84 and Weinstein J Absent from work: nature versus diet [Editorial]. Ann Intern Med January 20 2004;140:142-3

COPYRIGHT 2004 American Academy of Family Physicians

COPYRIGHT 2004 Gale Group