EFFECT OF INTENSIVE PATIENT EDUCATION VS PLACEBO PATIENT EDUCATION ON OUTCOMES IN PATIENTS WITH ACUTE LOW BACK PAIN: A RANDOMIZED CLINICAL TRIAL

Review written by Dr Sarah Haag info

BACKGROUND & OBJECTIVE:

Low back pain is the leading cause of disability worldwide, and a large portion of healthcare is directed at treating and managing low back pain. International guidelines recommend that practitioners provide ‘advice, education, reassurance, and simple analgesics, if necessary’. We know that 60% of people who experience low back pain will recover without intervention. However, the 40% that do not recover on their own incur most of the cost associated with low back pain. This study looked to determine the effect of intensive patient education in reducing acute low back pain.

METHODS:

The design of the study was assessor-blinded, 1:1 parallel group, randomized placebo-controlled trial, and was prospectively registered. Participants were referred from general practitioners or physiotherapists when they were seeking care for acute low back pain. All treatment was provided during the acute phase of low back pain, within 6 weeks of onset of pain. Each participant received guideline-based care from their referring provider, as well as receiving 2 x 1-hour individual, face-to-face sessions of either patient education or placebo patient education. Patient education sessions were adapted from the book ‘Explain Pain’, which is typically used for people with chronic pain. The placebo patient education was used to control for time with an expert clinician. The placebo group clinicians listened and showed interest in the patient, but offered no advice, information or education.

RESULTS:

Patient education was not more effective than placebo patient education at reducing pain intensity at the end of the 3-month follow-up period, though both groups had a decrease in pain intensity of >2 points. The patient education group showed a

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