Introduction. Back pain is a major problem in the workplace. Back pain is also responsible for considerable economic costs and can have serious social repercussions in our society. In this study we present the results of four years of study combining the findings of two different medical teams involved in the treatment of chronic back pain: the occupational health department in Brest (service de sante au travail en Iroise [STI], Brest and a service of physiotherapy and rehabilitation medicine in Roscoff, France.Methodology. Our model is based on the diagnosis of a problem of chronic back pain in various workers. The diagnosis is proposed by doctors associated with the occupational health department of Brest, based on a specific protocol that covers workers who have been suffering from chronic back pain for more than 3 months with an obvious impact on the quality of their work. Each individual medical case was then studied by a joint medical committee composed of doctors specialized in occupational health concerns and doctors specialized in physical rehabilitation. On the basis of the committee's findings, it has (or not) been possible to offer to the back pain sufferers a series of physical therapy and functional re-education sessions, as well as an ergonomic study of their workstation. One year later, a new evaluation of the situation was systematically undertaken by comparing the ODI, HADS and Karasek tests for each individual.Results. One hundred and eighty-three workers were presented to the joint committee of occupational health practitioners and physical rehabilitation specialists between 2010 and 2013. Each case was then re-evaluated one year later. Only 90 cases were taken in charge by the rehabilitation and functional re-education center. Seventy-one cases were re-evaluated by the committee of doctors one year later. Among these cases, 18 workers were declared unfit with no work resumption. Seven of the original 90 cases were lost from sight. After one year, 78.9% of the subjects included in the program were working, whereas only 55.7% of them were on their jobs at the beginning of the program. A total of 67.9% of the patients (or workers) declared that they felt a physical improvement in their back pain. Seventy-five percent of the patients were recognized as disabled workers. On average, their ODI score was improved (by 10 points) as well as their psychological profile, in terms of less depression and less anxiety.Discussion. We compare our model to other types of health care offered to patients suffering from chronic back pain, especially the Sherbrooke model. We confirm the importance of multidisciplinary care based on the bio-psychosocial well-being profile. The first results we are publishing are more positive than those presented in other studies, although it is difficult to compare this particular "protocol" with others. On the other hand, we found no clear benefit in the ergonomic adaptation of the workstation, unlike other studies. However, the benefits of physical rehabilitation/re-adaptatiOn, (and sports) are confirmed. A global approach using a well-defined protocol that takes in charge patients (workers) suffering from chronic back pain by an occupational health service and then through a close relationship with a physical rehabilitation center has provided encouraging results. However, it is still possible to improve these results, especially by integrating suggestions by specialists in ergonomics with those of the occupational therapists in order to optimize the adaptation of certain workstations. (C) 2015 Elsevier Masson SAS. All rights reserved.

L'evolution demographique dont depend la structure de la population impose et imposera qu'une plus grande attention soit apportee par le medecin du travail dans l'evaluation des capacites et aptitude au travail en fonction du viellissement et dans un contexte plus large par les acteurs de sante au travail.