A trial of modern rehabilitation for chronic low-back pain and disability. Vocational outcome and effect of pain modulation.

Of 66 nonoperated low-back pain patients who entered a 4-week program of modern active rehabilitation after 13 months' sick leave, only 15 (23%) had returned to work at 18 months' follow-up. Effective pain modulation with pool traction did not influence the vocational status or pain level at the time of follow-up. The prevalence of blue-collar workers among the clients were doubled compared with the general population, and a high proportion were unskilled (71%). It is concluded that the resources of health services should be used in the subacute stage to produce an earlier and more precise organic and psychosocial diagnosis and to state the preference of an active attitude supported by general physical training.