Workers' Compensation Internet Low Back Pain Study

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Low back pain (LBP) affects as much as 50 percent of the workforce in any one year, and is the most common cause of compensation claims. In addition, low back pain accounts for about 33 percent of all workers' compensation costs. The Agency for Health Care Policy and Research published guidelines for dealing with LBP that support the use pf patient education. Unfortunately, most patient education efforts, most commonly "back schools, " have shown only modest evidence of the ability to reduce pain, encourage return to work, or prevent days lost from work. In addition, they have not been shown to reduce days lost from work or health care utilization. One reason for the limited effectiveness of these programs appears to be their medicalization of the condition and their focus on just exercise and body mechanics. We propose to evaluate, in a randomized study, a new generation LBP program, which will differ from former programs in its emphasis on decision making, problem solving, and early return to normal activity. The mode of instruction will be personalized ongoing group education through a closed, moderated internet email discussion group, together with supportive materials, a book and videotape. The aim of the study is to develop and evaluate, in one-year exploratory randomized trial, an internet email discussion group intervention for injured workers with LBP receiving workers' compensation benefits. The four categories of outcomes will be 1) health related quality of life, 2) work disruption, 3) health care utilization, and 4) satisfaction. If successful, this study will pioneer a new generation of LBP interventions for injured workers. The intervention has the potential of improving health-related quality of life and reducing days lost from work and health care utilization. It is low-cost and easily replicable.