Researchers in the Netherlands conducted a systematic review by analyzing 24 studies of adults who experienced both short-term and chronic lower back pain. The studies used various forms of education, including discussions with health care providers, group classes, videos or written information, to help patients better understand and manage their back pain.
The analysis revealed that patients who experienced short-term lower back pain, and who received 2.5 hours of individual patient education sessions with a health care provider, were able to return to work faster than if they had received no education.
Such individual education sessions can help patients learn how to stay active, cope with back pain, avoid strains and reduce the risk of future back pain episodes. A well-educated patient, therefore, may be able to return to work more quickly.
For example, the research indicates that after 7 months, 60 percent of short-term back pain patients who did not receive education remained on sick leave, compared to the 30 percent who received educational sessions. Those who suffer from chronic back pain, however, are less likely to benefit from patient education.
“The main goal in the treatment of nonspecific low back pain is to stimulate the patient to remain or become more active despite the pain, in a time-contingent manner,” said lead reviewer Arno Engers. “Different interventions are advised, but the main goal in most cases is to change the orientation in the patient from a pain focus to an activity focus.”
Intensive Education in United States “Uncommon”
While Engers noted that the 2.5-hour sessions were most effective in helping short-term back pain patients return to work, he acknowledged that this much time usually is not devoted to individual patient education.
“To our knowledge, general practitioners have very limited time and it is presumed will take about 10 to 15 minutes for a total consultation, patient education included,” Engers said. “An extra problem in individual patient education is that it’s often not seen as an ‘intervention’ at all, not by physical therapists, or by patients or health insurance institutes.”
Dr. Roger Chou, associate professor of medicine at Oregon Health & Science University, added that patient education sessions in the United States rarely last as long as those reviewed by the Netherlands researchers.
“Most of the studies of intensive educational sessions were conducted in Europe, usually in countries where there is a very different system for caring for injured workers,” Chou said. “In the U.S., I think it is very uncommon outside of a few specialized clinics to provide the kind of intensive education that the Cochrane review found effective due to time and reimbursement issues.”
The review appears in the current issue of the Cochrane Library, a publication of The Cochrane Collaboration.
Another recent OccupationalHazards.com article, Heavy Lifting Training Won’t Prevent Back Strains, also addresses back pain and education.