Low Back Pain Clinical Trial
Official title:
The Right Intervention for the Right Patient
Complicated and expensive interventions are used to treat unspecific low back pain and the
intervention is not always targeted the patients specific problems.It is therefore not
surprising that a large fraction of unspecific low back pain patients do not respond very
well to the usual biopsychosocial intervention.
We would therefore like to identify the patients specific problems regarding the patients
biomedical, psychological, and social needs.
Two quality assurance investigations are performed in the The Back Research Center Clinic,
where one is published in The Spine. The systematics of Health Technology Assessment was
used to throw light on important indicators in relation to Health Technology aspects,
patient aspects, organisational aspects and economical aspects. At 12 months follow up in
1999, approximately one third of the patients stated that their low back pain was unchanged
or worse. In 2004 in a new investigation this fraction was larger. Therefore it seems
relevant to be able to identify the patients early in their course in the back ambulatory.
A Norwegian project has shown that when one divides the patients into 3 levels of severity,
then the interdisciplinary biopsychosocial intervention had best effect in the intermediary
and severe groups. Conversely the mono disciplinary intervention had best effect on the
least severe patient group.
Therefore we would like to combine elements from the typical clinical investigation with a
screening for psychosocial factors in order to sort patients according to their individual
needs.
Even though the bio-psycho-social elements are a coherent continuum one can arbitrarily
combine them in 4 groups of increasing complexity.
- mainly biological
- both biological and psychological
- both biological and social
- both biological, psychological and social It is probably not good enough to give more
or less the same type of somatic treatment to all unspecific low back pain patients. It
is important to take into account all three elements, the severity of the elements, and
the combination of elements. To be able to do this it is important to use a combination
of screening instruments that can isolate and quantify the manifestations of the three
elements in the patients.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
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