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Mind and Body Matters for Getting Back to Work after Neck or Back Pain

Have you ever wondered if going to the gym to work out is really needed? Can't you just do a few exercises at home and get the same results? What about after a neck or back injury? Do physical conditioning programs really reduce the time lost from work?

Researchers from Australia and the Netherlands teamed up to find out. They looked at studies from around the world. They say specific exercises alone haven't been proven effective. Physical conditioning with a cognitive behavioral program get the worker back on the job in the least amount of time.

Physical conditioning? Cognitive behavioral programs? What are these, anyway? Physical conditioning or work hardening programs get the worker back in shape for his or her job. A physical or occupational therapist usually sets up and runs the program. If the worker can't lift, strength training is used. If the worker can't bend, twist, or turn, then the therapist teaches patients how to change the activity. Overall fitness and flexibility are also part of many back-to-work physical conditioning programs.

Behavioral cognitive therapy is used to change the way the worker thinks about back pain, the job, or the job tasks. Getting rid of negative emotions, thoughts, and behaviors is the key. Taking too much medication, moving too slowly, or just not doing what needs to get done are examples of negative behaviors. A behavioral cognitive program deals with these issues.

Looking over all the studies, the authors conclude that a physical conditioning program decreases sick leave time. In fact, as many as 45 work days are saved compared to usual care or advice from a doctor. They also found that industrial workers take more sick leave than patients in other settings who are seeing a doctor for the same kind of neck or back pain. The studies also show that physical conditioning works better than passive types of therapy.

References: Eva Schonstein, MHPEd, et al. Physical Conditioning Programs for Workers with Back and Neck Pain: A Cochrane Systematic Review. In Spine. October 1, 2003. Vol. 28. No. 19. Pp. E391-E395.

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