Back pain is the leading cause of work-related disability in America. It contributes to excessive medical, insurance, and legal costs for all Americans and results in billions of dollars in lost productivity for employees. At some point in their lives, 80% of the work force will suffer some form of back pain. While the American Pain Society recommends a multidisciplinary approach to pain management that integrates cognitive, physical, and educational interventions, workers have little access to these treatments. In sum, because most adults who suffer from back pain never receive treatment, there is a critical need to develop multidisciplinary pain management and prevention programs that can be easily implemented and widely disseminated. This project will develop and test an interactive multimedia program for back pain sufferers in the workplace who are not receiving medical care. The Internet/CD-Rom training program will include a Back Pain Assessment Tool, feedback and recommendations, and assistance with setting goals and developing a pain management action plan. It will be a repeat visit, multidisciplinary intervention incorporating cognitive- behavioral techniques (e.g., relaxation exercises, problem-solving, fear-reduction, etc.), physical techniques (e.g., stretching, alignment, strengthening, etc.) and education (e.g., about multidisciplinary approaches, ergonomics, life style issues). The program will incorporate video and animated tutorials, motivational peer testimonials, behavior modeling vignettes, and informational articles. The Phase I proof of concept will include (a) the Back Pain Assessment Tool, which will provide stage- tailored feedback with recommendations, (b) goal setting, and (c) action plan modules. It will be evaluated for feasibility on the Internet using a within-subject design. In addition, an independent panel of national experts in pain management will conduct a systematic review. The anticipated results from the Phase I trial will demonstrate utility, feasibility, and pre-post change with respect to pain management intentions, attitudes, and self-efficacy. In Phase II, the complete program will be developed and evaluated in a larger randomized trial on the Internet. The potential markets for the Phase II product are employee assistance firms, behavioral health organizations, health insurance companies, and pain management clinics. Back pain, which afflicts four out of five adults at some point in their lives, is best treated with a multidisciplinary approach combining psychological, physical, and educational strategies. Unfortunately, doctors lack time and training to incorporate such approaches, insurance companies don't cover them, and clinics offering them aren't readily available. The proposed Internet program provides broad access to a 6- week multidisciplinary back pain intervention. ? ? ? ?
| Irvine, A Blair; Russell, Holly; Manocchia, Michael et al. (2015) Mobile-Web app to self-manage low back pain: randomized controlled trial. J Med Internet Res 17:e1 |
