Which Pain Rehabilitation Programme Should Patients With Chronic Back Pain Attend? - A Practical Example of a Service Evaluation Based Upon Implementing Research Findings into Clinical Practice

Background: To evaluate a service reconfiguration of pain rehabilitation programmes for chronic back pain using three programmes of differing intensity and duration and a clinical algorithm. This study describes the outcomes for each programme for three consecutive cohorts. Method: Non randomised observational study of 120 consecutive patients with chronic pain treated by a Physiotherapy Department of a Specialist Orthopaedic and Rehabilitation hospital. Three different pain rehabilitation programmes each comprising of multidisciplinary rehabilitation with varying intensity and duration of content were compared for clinical and cost efficacy. The main outcomes used were Oswestry Disability Index (ODI), Pain visual analogue score (VAS), pain catastrophising scale (PCS), pain self efficacy questionnaire (PSEQ), Tampa scale for kinesiophobia (TSK) and physical tests of timed sit to stand and 5 minute walk test.