TREATMENT FOR HELPLESS WOMEN SUFFERING FROM CHRONIC SPINAL PAIN - A RANDOMIZED CONTROLLED 18-MONTH FOLLOW-UP-STUDY

This prospective randomized controlled outcome study was. designed to evaluate whether a MultiModal Cognitive-Behavioral Treatment for chron ic spinal pain (MMCBT) specifically designed for women has an increase d effect on well being and return to work compared to a regular MMCBT regimen. In Sweden, spinal pain is most prevalent among women. A treme ndous amount of money is spent on secondary prevention of spinal pain. Yet, little is known about the effect of the interventions. A need fo r well designed outcome studies exist. Fifty-four subjects from a coho rt of all registered sick-listed women in three districts of Stockholm participated in the study. Subjects were allocated by central randomi zation into two groups. One group was treated with a regular MMCBT pro gram and the other group with a MMCBT program specifically designed fo r women. Assessments were performed at pretreatment-posttreatment (las t treatment day) and at 6 and 18 months posttreatment. Questionnaires covering the bio-psycho-social spectra of the chronic pain syndrome, a nd sick leave were used to measure outcome. Intention to treat and tru e to protocol analyses were performed The only significant differences found between groups were improvements in self-reported disability an d in coping with pain, favoring the experimental treatment About one-t hird of the variance in disability was explained by the set of pain-co ping strategies assessed in the study. The results do not lend suffici ent statistical support to warrant acceptance of the experimental trea tment as superior to the regular treatment in improving health and sic k leave. Further investigation with larger groups is needed before a s olid scientific conclusion can be drawn.