Research: GOOSSENS and colleagues,

Listed in Issue 34


GOOSSENS and colleagues, Institute for Rehabilitation Research, Hoensbroek, The Netherlands. conducted a 3-year cost-effectiveness study and compared the efficacy of several types of rehabilitation programmes for chronic low back pain.



The authors compared a combined operant programme plus cognitive/relaxation programme with an operant programme plus attention-control. They then compared both programmes with a waiting-list control group and with operant rehabilitation provided by the same rehabilitation centre. 148 patients suffering from chronic low back pain were randomly assigned to the various programmes. Economic endpoints were the costs of the programme and other health care utilisation, costs for the patient, and the indirect costs associated with production losses due to low back pain.


The results of this 3-year study demonstrated that the addition of a cognitive component to an operant treatment did not result in significant cost differences nor improvements to quality of life compared to the operant treatment alone. Compared to the common individual rehabilitation therapy, it was concluded that the same effects can be achieved at the same or lower costs with a shorter, more intense standardised group programme . The operant treatment alone was more effective than providing no treatment in the waiting-list control group.



Goossens ME et al. Health economic assessment of behavioural rehabilitation in chronic low back pain: a randomised clinical trial. Health Econ 7(1): 39-51 Feb 1998.


As the above studies demonstrate, there is a considerable amount of research focussed upon determining the efficacy of complementary therapies in many health problems, with the intent of proving or disproving many commonly-held assumptions such as the use of relaxation for pain relief, and the inclusion of a cognitive component within a back pain treatment programme.

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