At some point in their lives, 80 percent of the work force will suffer some form of back pain. It is the leading cause of work-related disability in the U.S., costing billions of dollars in lost productivity and high medical, insurance, and legal costs. For workers suffering from nonspecific low back pain (NLBP) that does not require medical attention, the American College of Physicians (ACP) and American Pain Society (APS) recommend a multidisciplinary approach to pain management that integrates cognitive, physical, and educational interventions. However, this type of program is not commonly available. There is a critical need to develop evidence-based multidisciplinary NLBP programs that can be widely disseminated and reduce the financial, physical, and emotional impact of NLBP on employers and employees. The proposed project will finish development and evaluate the effectiveness of a six-week web-based multidisciplinary program for workers suffering from NLBP that does not require medical treatment. The website will have tailored strands for four different job-types: a) desk job, inactive (i.e., Phase I;workers who are seated 50 percent or more of the day);b) non-desk job - inactive (i.e., cashiers or food service workers who usually stand while working, but are relatively inactive otherwise), c) non-desk job, active (i.e., active physical labor, such as construction workers), and d) truck and heavy equipment operators (i.e., individuals who work while seated and are subject to heavy vibration). In alignment with the ACP and APS guidelines, the program will include a Back Pain Assessment Tool to screen out individuals who require medical care and most likely do not have NLBP, provide evidence-based information on self-care options (e.g., heat and ice), provide information on the use of over-the-counter medication, and offer cognitive behavioral training to reduce psychosocial risk factors (e.g., fear and avoidance). The program will assist users in setting behavioral treatment goals and will help them schedule return visits. The program will incorporate video and animated tutorials, motivational peer testimonials, behavior modeling demonstrations, and informational articles. The Phase I prototype was assessed by a panel of experts, including physicians and members of APS, and was tested by an Internet sample of workers experiencing low back pain. Evaluation results indicated the program accurately developed appropriate educational approaches for case studies presented by the expert panel. Internet users were very satisfied with program content, functionality, and usability, and they showed significant gains in measures of knowledge, self-efficacy, attitude, and intentions. In Phase II, the complete program will be developed and evaluated in a randomized controlled trial with 300 workers diagnosed with NLBP. The evaluation will be conducted entirely online, across the United States.
Back pain, which afflicts 80 percent of adults at some point in their lives, is best treated with a multidisciplinary approach combining psychological, physical, and educational strategies. Unfortunately, workers who suffer nonspecific back pain that does not require medical care have few options. Doctors focus on patients with underlying conditions, and clinics offering multi-disciplinary care for back pain aren't readily available. In response, the proposed Internet program will provide worksite employees with a 6-week multidisciplinary intervention for self-treatment of back pain.