How do disability duration and functionality-improvement results from a disability management approach using a medical model focused on reducing pain differ from an integrated-care approach that focuses on return to function and return to work? A randomized control study design (the research "gold standard" for such interventions) provides dramatic evidence of new and effective strategies for dealing with difficult low-back-pain cases. This research emphasizes the importance of a "holistic" approach - engaging the employee, the medical provider and the employer to manage the full impact of serious low-back pain.