Seven studies (n=1,450) were included in the review and another two studies from a previous review were included in the meta-analyses. Where reported, four studies were judged as moderately high quality. Follow-up ranged from six months to three years.
Compared with conservative treatment, multidisciplinary rehabilitation significantly increased the rate of return to work in all patients with sub-acute and chronic pain (RR 1.15, 95% CI 1.09 to 1.21; eight studies).
Subgroup analyses showed that multidisciplinary rehabilitation significantly increased the rate of return to work in patients with sub-acute pain compared with conservative treatment (RR 1.16, 95% CI 1.09 to 1.23; six studies). There was no significant difference in the rate of return to work between the two groups in patients with chronic pain.
When only studies from Scandinavia were considered, multidisciplinary rehabilitation significantly increased the rate of return to work compared with conservative treatment (RR 1.21, 95% CI 1.13 to 1.31; five studies).
Significant heterogeneity was only observed in the outcome of return to work when all the studies were pooled (I2=53.5%) and when only studies with patients of subacute pain (I2=62.5%) were pooled. The possibility of publication bias was found in the outcome of return to work when all the studies were pooled, but not when only studies from Scandinavia were pooled.