Pain Education May Not Improve Acute Low Back Pain
During patient education sessions, pain, biopsychosocial pain contributors, and self-management strategies were discussed.
The addition of a 2-hour patient education session to first-line care may not benefit patients with acute low back pain, according to a study published in JAMA Neurology.
A total of 202 patients with acute low back pain for <6 weeks were recruited from general practice, physiotherapy clinics, and a research center in Australia. In addition to first-line care, study participants were randomly assigned to receive two 1-hour educational sessions (n=101) or placebo patient education sessions (n=101). During patient education sessions, pain, biopsychosocial pain contributors, and self-management strategies (eg, physical and pacing activities) were discussed. Placebo education sessions consisted of active listening without additional information or advice.
Pain intensity at 3 months (evaluated with an 11-point numeric rating scale) was the study's primary outcome. Additional outcome measures were disability at 1 week and at 3, 6, and 12 months, assessed using the 24-point Roland Morris Disability Questionnaire.
At all points, retention rates were >90% in both groups. The addition of patient education vs placebo to first-line care was not associated with greater efficacy in reducing pain intensity at the 3-month follow-up (mean difference, −0.3 point [2.1 vs 2.4, respectively]; 95% CI, −1.0 to 0.3; P =.31). Patient education improved disability at 1 week (mean difference, −1.6 points; 95% CI, −3.1 to −0.1 points) and 3 months (mean difference, −1.7 points; 95% CI, −3.2 to −0.2 points).
"Adding complex, time-consuming treatments to primary-care based advice and reassurance is likely to be unnecessary for most patients with acute low back pain," concluded the study authors.
Traeger AC, Lee H, Hübscher M, et al. Effect of intensive patient education vs placebo patient education on outcomes in patients with acute low back pain: A randomized clinical trial [published online November 5, 2018]. JAMA Neurol. doi: 10.1001/jamaneurol.2018.3376