The major cost associated with chronic low back pain is the patient's inability to work that may culminate in chronic permanent disability. 

Therefore, reducing sick days is essential.  Research must therefore show whether patients exposed to functional rehabilitation does better in keeping patients at work compared to those patients who receive pain centered rehabilitation. 

Functional rehabilitation emphasizes activity despite pain by work simulation, strength, endurance and cardiovascular training.  Work hardening and slowly progressive activity programs encourage patients to continue the activities even if pain increases. 

Pain centered rehabilitation emphasizes pain reduction using passive and active mobilization, stretching, strengthening and back school with education and exercise.  Such programs may use exercises of moderate intensity together with supportive treatment such as hot packs, electrical stimulation therapy or massage.  Activities and exercises that increase pain are avoided.   

A recent study with long term follow-up of one year showed that patients with chronic lower back pain who were exposed to functional rehabilitation did better by having more work days than patients who underwent pain centered training. 

Arch Phys Med Rehabil 88: 1089-1094, 2007

Tags: exercise, function, low back, lower body topics, pain, rehabilitation, work days
Categories: Lower Body Topics, Pain