• T Seferlis, L Lindholm, and G Németh.
• Department of Orthopaedics, Karolinska Hospital, Stockholm, Sweden.
• Scand J Prim Health Care. 2000 Mar 1; 18 (1): 53-7.

ObjectiveTo perform a cost-minimization analysis of three conservative treatment regimes for acute low-back pain (LBP).DesignA prospective randomized clinical trial. Patients were assigned at random to one of three treatment programmes: General Practitioner Programme (GPP-) controls, Manual Therapy Programme (MTP) or Intensive Training Programme (ITP).SettingPrimary care and physiotherapists in Stockholm, Sweden.Patients180 patients sick-listed for acute LBP.Main Outcome MeasuresDirect, indirect and total costs for three treatment programmes.ResultsThe direct costs for treatment were lowest in the GPP group -- 2744 Swedish crowns (SEK) per patient. More patients in the MTP and ITP underwent operations for disk hernia and radiological investigations than in the GPP. Indirect costs, defined as sick-leave for LBP represent about 90% of the total cost.ConclusionsWith respect to total costs, the findings were similar between the three treatment programmes. The GPP had the lowest direct costs. It is not possible to conclude which treatment programme is to be recommended as a least cost alternative. The strong effect of indirect costs on the total cost stresses that further studies should focus on methods of shortening sick-leave.

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