STUDY DESIGN: A multicenter, randomized, single blinded-controlled trial with one-year follow-up. OBJECTIVES: to evaluate the efficiency of the progressively graded medical exercise therapy (MET), conventional physiotherapy (CF) and self exercise by walking (SE) in patients with chronic low back pain. SUMMARY OF BACKGROUND DATA: Varieties of MET and CP are considered to reduce symptoms, improve function and decrease sickness absence, but this opinion is controversial. METHODS: Patients with chronic LBP or radicular pain sick listed for more than 8 weeks and less than 52 weeks (Sickness Certificate 2) were included. The treatment lasted for 3 months (36 treatments). Pain intensity, functional ability, patient satisfaction, return to wor, number of days on sick leave and cost were recorded. RESULTS: Of the 208 patients included in this study, 71 were randomly assigned to MET, 67 to CP and 70 to SE. 33 (15.8%) patients dropped out during the treatment period. No difference was observed between the MET and CP groups, but both were significantly than the SE group. Patient satisfaction was highest for the MET. Return to work rates were equal for all 3 intervention groups at assessment 15 months after therapy was started, with 123 patients were back to work. In terms of cost for days on sick leave, the MET group saved 906.732 Norwegain kroner (NOK) and the CP group saved NOK 1.882.560 compared with the SE group. CONCLUSIONS: The efficiency of MET and CP is shown. Leaving patients with chronic low back pain untampered poses a risk of worsening the disability with longer periods of sick leave.

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