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Exercise and work-oriented back pain management programs

Health Factors: Employment
Decision Makers: Employers & Businesses Healthcare Professionals & Advocates
Evidence Rating: Some Evidence
Population Reach: 1-9% of WI's population
Impact on Disparities: No impact on disparities likely

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Description

Low back pain affects many working adults. Exercise interventions, such as graded activity programs, can involve specific exercises for strengthening back muscles or flexibility, or exercises to increase strength and fitness generally. Physical conditioning programs are sometimes also called work conditioning, work hardening, or functional restoration/exercise programs and are generally designed by physical therapists.

Expected Beneficial Outcomes

Reduced absenteeism
Reduced pain

Evidence of Effectiveness

There is some evidence that exercise programs targeting lower back pain (LBP), especially in the workplace, reduce sickness absence and promote return to work (Cochrane-Hayden 2005, Cochrane-Schaafsma 2013, Oesch 2010, van Middelkoop 2010, Bell 2009). Additional evidence is needed to confirm effects.

Exercise programs can increase the likelihood that patients on work disability due to non-acute LBP return to work (Oesch 2010). Graded activity exercise programs in the workplace can reduce sick leave usage among employees suffering from sub-acute LBP (Cochrane-Hayden 2005). Intense physical conditioning programs (six or more sessions) may reduce sickness absence due to chronic back pain, and have also been shown to be effective for sub-acute pain when an explicit workplace component is included (Cochrane-Schaafsma 2013). Light conditioning programs (five sessions or fewer) appear to have no effect on sub-acute or chronic LBP, and there is no evidence light or intense physical conditioning programs reduce sick leave duration for acute LBP (Cochrane-Schaafsma 2013).

Exercise therapy can also reduce the severity of back pain and related physical disability (van Middelkoop 2010, Bell 2009, Cochrane-Hayden 2005).

Citations - Evidence

Bell 2009* - Bell JA, Burnett A. Exercise for the primary, secondary, and tertiary prevention of low back pain in the workplace: A systematic review. Journal of Occupational Rehabilitation. 2009;19(1):8-24. Accessed on November 30, 2015
Cochrane-Hayden 2005* - Hayden J, Tulder MW, Malmivaara A, Koes BW. Exercise therapy for treatment of non-specific low back pain. Cochrane Database of Systematic Reviews. 2005;(3):CD000335. Accessed on December 8, 2015
Cochrane-Schaafsma 2013* - Schaafsma FG, Whelan K, van der Beek AJ, et al. Physical conditioning as part of a return to work strategy to reduce sickness absence for workers with back pain. Cochrane Database Systematic Reviews. 2013;(8):CD001822. Accessed on December 8, 2015
Oesch 2010 - Oesch P, Kool J, Hagen KB, Bachmann S. Effectiveness of exercise on work disability in patients with non-acute non-specific low back pain: Systematic review and meta-analysis of randomized controlled trials. Journal of Rehabilitation Medicine. 2010;42(3):193-205. Accessed on May 20, 2016
van Middelkoop 2010* - van Middelkoop M, Rubinstein SM, Verhagen AP, et al. Exercise therapy for chronic nonspecific low-back pain. Best Practice & Research Clinical Rheumatology. 2010;24(2):193-204. Accessed on November 18, 2015

Page Last Updated

April 5, 2014

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