Early complex occupational add-on,
does it really help with Reduced six-month cumulative low-back-pain sick leave in workers with physically demanding jobs?
research showsThe grade is D with 34 points. The Danish GOBACK trial randomized 305 participants, but cumulative six-month low-back-pain sick leave was 18.54 versus 15.49 days, adjusted mean difference +3.50 days (95% CI -5.08 to 12.07; P=.422), with no reduction from the add-on. Every secondary outcome, including pain, disability, fear avoidance, and quality of life, also showed no between-group difference. The interval still ranged from about five days of benefit to twelve days of harm, so useful benefit was not precisely excluded.
ads claimThe finding does not mean every occupational intervention for low back pain is ineffective. It means this specific three-month package did not add sick-leave benefit after examination, MRI explanation, and advice to stay active and working.
Useful facts when choosing a product
- The registration is NCT02015572.
- Both groups received examination, MRI explanation, and advice to remain active and working.
- The prespecified intention-to-treat analysis included all 305 participants and used multiple imputation.
What the research actually shows
This single-center open-label superiority trial randomized 153 participants to the add-on and 152 to no add-on. Both groups first received clinical examination and MRI, an explanation of pain, and advice to remain active and continue working. Only the intervention group received three months of occupational consultation, work evaluation and planning, optional workplace visits, and physical activity. The primary analysis used all 305 randomized participants; the paper states, 'Multiple imputation was used for missing observations.' An independent statistician generated the computer list, administered through 'sealed envelopes.' However, unblinded participants recorded weekly paper diaries attributing sick leave specifically to low back pain, an avoidable subjective-outcome limitation. Funding came from the Danish Working Environment Research Fund and Oak Foundation, with no funder role. Verdict 1569 is D with 25 points for lifting education and assistive-equipment training to prevent low back pain; that prevention question differs from adding this program for workers who already had pain and enhanced usual care.
Why this is classified as D (34)
A publicly funded randomized hard-outcome trial was null; one trial, open-label self-attributed sick leave, and a wide interval give D with 34 points.
Counterpoint. D does not mean useful benefit was precisely excluded. The interval leaves both benefit and harm possible.
Rejudgment record. Cross-check applied — The sick-leave primary outcome and all secondary outcomes were null in a publicly and noncommercially funded randomized trial, but the interval retained benefit and harm and sick leave was self-attributed in an open-label trial
| Endpoint | H | Hard endpoint - actual events such as death |
| Replication | R1 | Single confirmatory trial |
| Independence | I2 | Decisive evidence is publicly or non-profit funded |
| Effect size | E0 | Null |
| Precision | C0 | The confidence interval leaves room for benefit |
The scoring table and the verdict agree (D).
Sub-claim grades by effect
This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.
| Effect (sub-claim) | Grade | Basis |
|---|---|---|
| Reduced six-month low-back-pain sick leave | D | The adjusted difference was +3.50 days and null, with the interval retaining both benefit and harm. |
Cross-check — Codex and Claude
Evidence Table
| Study | Design | Sample | Funding | Endpoint | Result | Weight |
|---|---|---|---|---|---|---|
| Study 1 | Single-center pragmatic open-label randomized superiority trial | 152 | Danish Working Environment Research Fund and Oak Foundation | Cumulative low-back-pain sick-leave days over six months | 18.54 versus 15.49 days; adjusted mean difference +3.50 days (95% CI -5.08 to 12.07), P=.422; no between-group differences in any secondary outcome | Single publicly and noncommercially funded null trial |
Receipt — 2 References
All 2 cited sources were verified for existence at the original page (as of 2026-08-18).
Reviewed and approved: Chamgap Editorial Team · Approval date: 2026-08-18 · Corrections: none
Cite this verdict
[Chamgap] Early complex occupational add-on x low-back-pain sick leave in manual workers — Evidence Grade D·34. 2 cited sources checked. Source: https://chamgap.com/en/verdicts/joint-bone/early-occupational-add-on-low-back-pain-sick-leave/ · CC BY 4.0CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.
What this document does and does not do
Chamgap is an information source. It reports what research has and has not confirmed; it does not tell readers what to take or buy. That decision belongs to readers and, when needed, medical or legal professionals. This verdict reflects literature available up to the search date and may change as new research appears. Nothing here is medical advice.