MANAGEMENT OF OCCUPATIONAL BACK PAIN - THE SHERBROOKE MODEL - RESULTSOF A PILOT AND FEASIBILITY STUDY

Objectives-The aim was to combat occurrence of chronic occupational ba ck pain.Methods-A multidisciplinary model to manage back pain that inc ludes both clinical and ergonomic approaches has been developed. Early detection,early clinical and ergonomic evaluations, and early active treatment make up the cornerstone of management. Detection of cases st arts after four weeks of absence from work. An ergonomic intervention is implemented at six weeks. A medical specialist is involved at eight weeks. If return to work is not possible; after 12 weeks, a functiona l recovery therapy followed by a therapeutic return to work is impleme nted. A multidisciplinary team. decides if return to original or modif ied work is possible or if vocational rehabilitation is necessary. Thi s model has been implemented by the investigators in the Sherbrooke (Q uebec, Canada) area, and is presently being evaluated through a random ised trial in 31 industrial settlements (about 20 000 workers). A clus ter randomisation of industries and workers will allow separate testin g of ergonomic and clinical interventions.Results-One year after imple mentation, 31 of 35 of the eligible industrial sites participated in t he study and 79 of 88 of the eligible workers affected by recent back pain had agreed to participate. Ergonomic and clinical interventions h ave been implemented as planned. Only three workers dropped out. Hence this global clinical and ergonomic management programme has been show n to be feasible in a general population. Conclusion-A global manageme nt programme of back pain joining ergonomic and clinical intervention with a multidisciplinary approach has not been tested yet. Linking the se two strategies in a same multidisciplinary team represents a system ic approach to this multifactorial ailment. During the first year of t his trial we did not find any conflict between these two interventions from the employer's or worker's point of view.