Quality of life in chronic low back pain patients after multidisciplinary treatment in Austria

Abstract Background Low back pain (LBP) is the leading global cause of disability, accounting for 8.1% of years lived with disability. Health-related quality of life (HRQOL) is an important factor in the evaluation of LBP interventions. International guidelines support multidisciplinary care, including physical, psychological, and complementary therapies. In Austria's Gastein Valley, LBP patients receive such care, including low-dose radon via balneo- or speleotherapy. This study assessed alterations in EQ5D-5L™ utility (0-1) and Visual Analogue Scale (VAS; 0-100) scores in patients with chronic LBP after multidisciplinary spa therapy in the Gastein valley. Methods Longitudinal data from 337 LBP patients in the “Gastein Health Registry,” were used. Questionnaires were completed at baseline (T0), after treatment (T1), and at 3 (T2), 6 (T3), and 9 (T4) months. Therapy (∼17.5 days) included exercise, back training, ergometer use, and low-dose radon. Mixed-effects linear regression models included timepoint, age, sex, BMI (fixed effects), and patient ID (random effect) with EQ5D-5L™ utility scores or VAS as outcome. Results Mean age was 57 years (SD 8.3; range 30 to 83); 52% were women; mean BMI was 26.5 (SD 4.0; range 18.0 to 42.7). EQ5D-5L utilities and VAS improved significantly at all timepoints compared to T0 (B [95% CI]; utilities): T1: 0.07 [0.06; 0.08], T2: 0.06 [0.05; 0.07], T3: 0.05 [0.04; 0.06], T4: 0.04 [0.03; 0.06]; (B [95% CI]; VAS): T1: 12.58 [10.83; 14.33], T2: 11.66 [9.88; 13.43], T3: 9.02 [7.20; 10.84], T4: 8.51 [6.68; 10.34]. Conclusions Multidisciplinary therapy with low-dose radon was associated with sustained HRQOL improvements in chronic LBP supporting the real-world effectiveness of guideline-concordant, multimodal interventions. Given the global burden of LBP, these results highlight the value of integrative rehabilitation approaches for informing public health strategies and guiding resource allocation by policymakers. Key messages • Guideline-concordant, multimodal interventions including low-dose radon are effective in improving perceived health status and utility-based quality of life. • Integrative rehabilitation approaches are of value or informing public health strategies and guiding resource allocation by policymakers.