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Working Your Way Through Back Pain

Most people experience loss when they miss work due to an injury. Sure, the first few days are fine, especially if you're being compensated for the time off, but eventually, a feeling of missing out sets in - many times accompanied by monetary concerns or a sense of reduced "job security." The longer you're out, the stronger the feeling can grow.

The occupational health services department of a major Dutch airline took part in a randomized, controlled trial comparing traditional spine care to behavior-oriented "graded" activity.

Employees who had been absent from work due to low back pain were assigned to receive graded activity or usual care from their doctor for three months, or until they returned to work. The graded activity program showed impressive results, with patients missing an average of 58 days (over six months of follow-up), versus 87 days for those under usual care.

What exactly is "graded" activity? In this study, it consisted of aerobic exercise (i.e., rowing, cycling); strengthening exercises (i.e., sit-ups, leg presses, latissimus pull-downs); and those tailored to each worker's regular duties (such as lifting and setting down suitcases, e.g., for baggage handlers). This was combined with praise and consistent feedback from the treating physiotherapists, with attention paid more to "improvements rather than pain."

You have a choice: You can place your recovery in the hands of the "usual" care providers, who often rely on pain medications, or you can utilize the services of an expert in treating back pain and getting you back on the job as soon as possible: a doctor of chiropractic.


Staal JB, Hlobil H, Twisk JWR, Smid T, Köke AJA, van Mechelen W. Graded activity for low back pain in occupational health care. Annals of Internal Medicine, Jan. 20, 2004:140(2), pp77-84.

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