A friend of mine at work has suggested I try an intense training program he went through in order to get back to work after a long bout of low back pain. Our insurance doesn't cover it. He assures me it was worth it. Is something like this really worth the money?

Comparing the cost-benefit of various back care programs is very difficult. First of all, patients are very different from one another. They may not have the same kind of back pain. The cause of the back pain may differ, too. Patient motivation and compliance with the program is also important.

These kinds of comparisons can be like the proverbial comparison of apples to oranges. Having said all of that, there are some studies published trying to sort out all the variables and factors in cost, savings, and benefits of treatment for back pain.

A recent study from the Netherlands compared the results of usual care with a physiotherapist (PT) versus a specialized intensive treatment program. Patients in the usual care group were examined by the PT. An individual program was prescribed and supervised based on published low back pain guidelines. Patients were treated one to two times each week for six weeks.

A second group was also treated by the PT. This group received intense training including back school education, behavioral training, and exercise therapy. They met 20 times as a group and each one had 10 individual sessions with the therapist.

All the direct and indirect costs were compared between the groups. The intervention group cost more, and the results were the same between the groups. The thing to remember though is that both groups had some kind of physiotherapy treatment. The study did not include a control group of patients who had no treatment.

You may want to see a physiotherapist for a consultation. Find out what treatment is possible and what to expect. Or find out more about the program your friend went through. Can it be adapted for your specific needs? How long does it take? How much does it cost?

Once you evaluate all of these factors, you may be closer to coming up with the right answer for your own situation.

Nicole van der Roer, PhD, et al. Economic Evaluation of an Intensive Group Training Protocol Compared with Usual Care Physiotherapy in Patients with Chronic Low Back Pain. In Spine. February 15, 2008. Vol. 33. No. 4. Pp. 445-451.