A model for the prevention of iatrogenic disease associated with work-related low back pain.

A review of national statistics related to workers' compensation strongly suggests that the current system for managing work-related back pain is not only ineffective but may actually promote disability. It is this author's view that a comprehensive unifying solution exists within the military "forward treatment" model used to prevent iatrogenic disability in battle fatigue casualties. Because military personnel and employed workers are similarly entitled it is felt that this proven model may likewise be effective in the prevention of iatrogenic disability in the worker with a job-related back injury. The model, acronymed SPICE, includes five components: Simplicity, Proximity, Immediacy, Centrality, and Expectancy.