Patient Education Does Not Improve Pain Outcomes
Adding 2 hours of intensive patient education — which researchers said consists of several in-depth meetings with a trained health practitioner to discuss psychosocial contributors to pain and advice about pacing and activity — to recommended first-line care for patients with acute low back pain did not improve pain outcomes, according to findings recently published in JAMA Neurology.
“It is unknown whether intensive patient education, in addition to recommended first-line care, can improve outcomes for patients with acute low back pain. To address this gap in the literature, we conducted, to our knowledge, the first randomized, placebo-controlled trial of patient education for acute low back pain,” Adrian C. Traeger, PhD, a postdoctoral research fellow at The University of Sydney, and colleagues wrote.
Researchers randomly assigned 202 patients with low back pain for fewer than 6 weeks and at high risk for chronic low back pain based on the validated prognosis model known as Predicting the Inception of Chronic Pain (PICKUP) in a 1:1 ratio to either patient education or placebo patient education. Of that total, 103 were female, the mean age of the participants in the study was 45 years, and more than 90% of the patients completed the 12-month study.
Traeger and colleagues found intensive patient education was not more effective than placebo patient education at reducing pain intensity (3-month mean pain intensity: 2.1 vs. 2.4 on an 11-point scale). The intensive patient education affected the secondary outcome of disability on a 24-point scale at 1 week (mean difference, –1.6 points) and 3 months (mean difference, –1.7 points) but not at 6 or 12 months.
“Our results challenge a widespread belief that patient education is an effective strategy for treatment of acute low back pain,” researchers wrote.
“For example, every clinical guideline recommends patient education to manage acute low back pain. These recommendations are, however, often unaccompanied by an evidence statement (eg, neither U.S. nor U.K. guidelines cite evidence for patient education) or instruction on how patient education interventions should be conducted,” Traeger and colleagues added.
The ongoing opioid crisis has led to a plethora of research and data examining low back pain reduction methods that do not involve opioids. As a courtesy to its readers, Healio’s coverage of some of this research and data are below. – by Janel Miller
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Mindfulness briefly, but insignificantly, relieves low back pain
Mindfulness-based stress reduction practices offer short-term improvements in pain and function for patients with low back pain; however, these improvements were not clinically significant compared with usual care, according to findings published in Annals of Internal Medicine. Read more.
Disclosures: Traeger reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.