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The efficacy of Back School on chronic low back pain of workers of a pharmaceutical company in a Tehran Suburb. COPCORD stage II study


Professor Fereydoun Davatchi, Rheumatology Research Center, Shariati Hospital, Kargar Avenue, Tehran 14117, Iran. Email:


Aim:  Low back pain (LBP) is the second most frequent reason for seeking medical advice. Various treatments are proposed from no intervention, to analgesics, rest, exercises, local interventions and surgical procedures. Results and outcomes are differently reported. Back School (BS), a combination of patient education and physical exercises, seems to have good results. The aim of this study was to check the effect of BS in factory workers.

Patients and Methods:  All (70) workers were interviewed and 26 of them (37.1%) had chronic LBP. Secondary causes were excluded. Anatomy, physiology, biomechanics of the spine, correct postures at work and back exercises were taught. Pain on a visual analog scale (VAS) of 0–100, and Short Form (SF)-36 health survey were applied, before, at the end of BS sessions, and 3 months after BS. Analysis was done by t-test, Wilcoxon and Pearson’s correlation test.

Results:  The mean VAS on pain before BS was 43.4 ± 22.3, improving to 38.6 ± 17.5 at the end of BS. The difference was not significant (P = 0.19). The mean VAS improved to 27.5 ± 20 at 3 months after BS. The difference was significant compared to before BS (P = 0.001). The quality of life measured by the SF-36 questionnaire, did not improve significantly, except for two of its eight subgroups (Role Physical, Social Functioning) at the end of BS, and two of its subgroup (Mental Health, Social Functioning) at 3 months after BS.

Conclusion:  Among industrial workers, BS is mainly effective on pain, but is less evident on SF-36.