Multidisciplinary treatment programmes for long-term back pain

Do they work?

Yes. Taking part in an intensive programme of treatment may help your long-term (chronic) back pain.

What are they?

During a multidisciplinary treatment programme, you see a team of experts. Some of them treat your pain, while others help you cope better with things like depression, which may be making your pain worse.

The health professionals in the team can vary in different programmes, but you may see a doctor, physiotherapist, psychologist, social worker and occupational therapist. Intensive treatment programmes seem to work best if you get some kind of treatment every day.

You may be admitted to hospital to have your treatment. But usually you will see different therapists at a clinic.[1] You'll probably be taught some exercises to do at home. The following treatments have been included in programmes:[1]

• Education about your back
• Exercises for your back
• Cognitive behavioural therapy (CBT). This is a type of talking therapy where you talk to a therapist about how your back pain affects you. You try to work out ways of coping better with your back pain
• Treatment with hot and cold packs
• Transcutaneous electrical nerve stimulation (TENS). A small battery-operated device (TENS unit) is worn around the waist. It delivers continuous pulses of electricity to help relieve pain
• Massage
• Relaxation exercises
• Hydrotherapy (water massage).

Ask your doctor about what's available in your area.

How can they help?

If you've had back pain for more than three months, an intensive programme including a range of different treatments can reduce your pain and help you get on with everyday life.[1]

But you may need a lot of treatment to feel the benefit. In the studies we looked at, the people who were helped by an intensive programme had more than 100 hours of treatments.

Why should they work?

Back pain is different for everybody. And a treatment that works for one parson may not work for another.

If you're treated by a multidisciplinary team you'll be treated with a variety of approaches. This means there's a better chance that you will get a treatment that works for you.

For example, physical therapy may work for you, or massage, or behavioural therapy. But these treatments may not help someone else with back pain. But if they have can do relaxation and have education about back pain as well, these treatments might work for them.

Can they be harmful?

It seems unlikely that taking part in a multidisciplinary programme will do you any harm. The research we found didn't report on side effects from this treatment.

What's the evidence for multidisciplinary treatment programmes for long-term back pain?