+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Treatment Efficacy, Clinical Utility, and Cost-Effectiveness of Multidisciplinary Biopsychosocial Rehabilitation Treatments for Persistent Low Back Pain: A Systematic Review



Treatment Efficacy, Clinical Utility, and Cost-Effectiveness of Multidisciplinary Biopsychosocial Rehabilitation Treatments for Persistent Low Back Pain: A Systematic Review



Global Spine Journal 8(8): 872-886



Systematic review. To review the current literature on the treatment efficacy, clinical utility, and cost-effectiveness of multidisciplinary biopsychosocial rehabilitation (MBR) for patients suffering from persistent (nonspecific) lower back pain (LBP) in relation to pain intensity, disability, health-related quality of life, and work ability/sick leave. We carried out a systematic search of Web of Science, Cochrane Library, PubMed Central, EMBASE, and PsycINFO for English- and German-language literature published between January 2010 and July 2017. Study selection consisted of exclusion and inclusion phases. After screening for duplication, studies were excluded on the basis of criteria covering study design, number of participants, language of publication, and provision of information about the intervention. All the remaining articles dealing with the efficacy, utility, or cost-effectiveness of intensive (more than 25 hours per week) MBR encompassing at least 3 health domains and cognitive behavioral therapy-based psychological education were included. The search retrieved 1199 publications of which 1116 were duplicates or met the exclusion criteria. Seventy of the remaining 83 articles did not meet the inclusion criteria; thus 13 studies were reviewed. All studies reporting changes in pain intensity or disability over 12 months after MBR reported moderate effect sizes and/or p-values for both outcomes. The effects on health-related quality of life were mixed, but MBR substantially reduced costs. Overall MBR produced an enduring improvement in work ability despite controversy and variable results. MBR is an effective treatment for nonspecific LBP, but there is room for improvement in cost-effectiveness and impact on sick leave, where the evidence was less compelling.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 066016047

Download citation: RISBibTeXText

PMID: 30560041

DOI: 10.1177/2192568218765483


Related references

Efficacy, utility and cost-effectiveness of multidisciplinary treatment for chronic low back pain. Schmerz 26(2): 131-149, 2012

Multidisciplinary biopsychosocial rehabilitation for subacute low back pain in working-age adults: a systematic review within the framework of the Cochrane Collaboration Back Review Group. Spine 26(3): 262-269, 2001

Study protocol of cost-effectiveness and cost-utility of a biopsychosocial multidisciplinary intervention in the evolution of non-specific sub-acute low back pain in the working population: cluster randomised trial. Bmc Musculoskeletal Disorders 12: 194, 2011

Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis. Bmj 350: H444, 2015

Multidisciplinary biopsychosocial rehabilitation for neck and shoulder pain among working age adults: a systematic review within the framework of the Cochrane Collaboration Back Review Group. Spine 26(2): 174-181, 2001

Treatment of chronic low back pain: a randomized, clinical trial comparing group-based multidisciplinary biopsychosocial rehabilitation and intensive individual therapist-assisted back muscle strengthening exercises. Spine 35(5): 469-476, 2010

Cost Effectiveness of Multidisciplinary Pain Management Services for Chronic Back Pain: Systematic Review. Value in Health 18(7): A661, 2015

Cost-effectiveness of guideline-endorsed treatments for low back pain: a systematic review. European Spine Journal 20(7): 1024-1038, 2011

A systematic review of sociodemographic, physical, and psychological predictors of multidisciplinary rehabilitation - or, back school treatment outcome in patients with chronic low back pain. Spine 30(7): 813-825, 2005

The efficacy, safety, effectiveness, and cost-effectiveness of ultrasound and shock wave therapies for low back pain: a systematic review. Spine Journal 11(10): 966-977, 2011

Cost-utility analysis of a three-month exercise programme vs usual care following multidisciplinary rehabilitation for chronic low back pain. Journal of Rehabilitation Medicine 42(9): 846-852, 2010

Multidisciplinary biopsychosocial rehabilitation for subacute low back pain. Cochrane Database of Systematic Reviews 6: Cd002193, 2017

Multidisciplinary biopsychosocial rehabilitation for chronic low back pain. Cochrane Database of Systematic Reviews 2014(9): Cd000963, 2014

Cost-effectiveness of exercise therapy in the treatment of non-specific neck pain and low back pain: a systematic review with meta-analysis. British Journal of Sports Medicine 53(3): 172-181, 2019

Multidisciplinary Biopsychosocial Rehabilitation for Nonspecific Chronic Low Back Pain. Physical Therapy 96(6): 759-763, 2016