Impact of a web-based stress management and healthpromotion program on neck-shoulder-back pain in knowledge workers? 12 month randomized controlled follow-up

Introduction
The prevalence of neck-shoulder-back pain is high, white collar workers included. In rehabilitation multimodal treatment programs with cognitive therapy, physical therapy including relaxation programs and physical activity a positive impact on pain has been shown. Health promotive programs at work with evident effect are more sparse. The aim was to evaluate a web-based stress management program’s influence on neck-shoulder-back pain and pain-relatedness to stress in a working population including consideration of the anatomical location and gender.

Methods
A randomized prospective controlled study, observation points at baseline, after 6 months intervention and 12 months follow-up on 226 news media employees in two study groups and one control group was performed. Two study groups´ took part in a web-based stress management and health promotion program with different intensities during 6 month intervention. The control group had no intervention. All participants fulfilled a questionnaire at three observation points.

Results
Rate of participation 89%. Between groups no significant differences were found at any study point. Within groups, the study group with less intensive program improved in pain-relatedness to stress at follow-up. Between baseline and after intervention the group with more intensive program showed decreased low back pain, and the control group showed decreased pain-relatedness to stress. Within group differences varied according to pain localisation and gender, whereas inconsistent.

Discussion
The use of the web-based program, any level, did not show impact on pain in neck-shoulder-back or on pain relatedness to stress according to between-groups analyses after 6 month intervention and 12 month post intervention. This is not in accordance to rehabilitation studies, nor to CBT (cognitive behavioural therapy) studies of web based program. Some changes were seen in subgroups in within group analyses, not consistent though Conclusion: The present web-based stress management program did not have influence on pain and pain relatedness to stress in stress-intensive occupations