BACKGROUND: Because psychosocial factors are involved in chronic low back pain, a biopsychosocial approach to treatment is recommended. Physiotherapy and multidisciplinary treatment are considered suitable approaches, but to date little is known about the cost-effectiveness of these treatment options. PURPOSE: To systematically review the literature, comparing the effectiveness of multidisciplinary treatment and physiotherapy as treatment for chronic low back pain. METHOD: A literature search was conducted in databases of Medline, PsycINFO, PEDro, Embase, CINAHL and Cochrane using the following selection criteria: (a) patients with low back pain for a period of 12 weeks or more, (b) treatment provided by at least a human movement specialist and behavioural specialist, (c) control group treated with physiotherapy, (d) primary outcome measures are sick leave and/or healthcare consumption. The methodological quality (PEDro checklist) and clinical relevance of included studies were assessed, important study characteristics were summarized in tables, and a best evidence synthesis was performed. RESULTS: Seven studies were retrieved, of which three were double publications, leaving five studies for analysis. Two of the five were of good methodological quality (=> 6 points on the PEDro checklist). Physiotherapy and multidisciplinary treatment appeared to be equally effective with regard to pain, impairment, sick leave, and healthcare consumption. There was strong evidence that multidisciplinary treatment had a small positive effect on quality of life compared with physiotherapy. CONCLUSION: Results of this review suggest that physiotherapy and multidisciplinary treatment are equally appropriate for the treatment of patients with chronic low back pain. Because of the higher costs involved with multidisciplinary treatment, physiotherapy is the preferred treatment.

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