Education Alone Does Not Improve Outcomes In Patients With Acute Low Back Pain
In any profession, utilized interventions and methods change with incoming ideas and evidence. New concepts and treatments often advance ahead of clinical research trials aiming to support or refute their utilization. Within Physical Therapy, pain neuroscience education has become a popular topic of late. Education topics regarding the development and chronicity of persistent pain are being utilized to teach patients about their current symptoms. Although helpful, I often find some clinicians over utilize this intervention in place of other proven strategies in the management of patients with musculoskeletal pain. A recent study examined the impact of intensive pain education among patients with acute low back pain.
Traeger and colleagues published their findings on the impact of intensive low back pain education and self management strategies in the Journal of the American Medical Association Neurology (2018). Authors randomized 202 patients with acute low back pain to two, one hour sessions of either placebo education (active listening, without information or advice) or patient education (biopsychosocial aspects of pain, back pain self management). These education sessions were in addition to other first line treatments for low back pain including pain medication. Authors reported no improvement in pain outcomes between the education and active listening groups. Consistent with clinical management of acute low back pain, education should not be used in isolation but rather in conjunction with other proven treatments including spinal manipulation and exercise.