VOCATIONAL OUTCOME OF INTERVENTION FOR LOW-BACK-PAIN

Practical management guidelines for occupational health physicians are needed for the individual support of employees with low-back pain. In this study the level of evidence regarding the efficacy of interventi on with vocational outcome parameters was assessed. In a systematic li terature search, 40 randomized clinical trials on different types of i ntervention were retrieved. Their internal validity and statistical po wer criteria were assessed. The randomization procedure, blinding of p atients, and sample size were problematic in most studies. For patient s with acute low-back pain limited or moderate evidence was found for the efficacy of no bed rest, a short period of bed rest, and spinal ma nipulation. For chronic patients limited evidence was found for the ef ficacy of antidepressants. For the other types of intervention, studie s with sufficient statistical power were lacking. Such studies are nee ded before more-detailed evidence-based guidelines can be formulated f or occupational health care.