Education in the management of low back pain: literature review and recall of key recommendations for practice

Ann Phys Rehabil Med. 2011 Jul;54(5):319-35. doi: 10.1016/j.rehab.2011.06.001. Epub 2011 Jul 1.
[Article in English, French]

Abstract

Introduction: Therapeutic patient education (TPE) is a continuous medical care process whose role in lower back pain (LBP) has yet to be well defined.

Objective: To evaluate the role and impact of TPE in the medical and surgical management of LBP.

Method: A non-systematic literature review.

Results: Few formal TPE programmes have been rigorously evaluated in the context of LBP. In most cases, TPE tools have been combined with other interventional measures that vary according to the conceptual models used - thus limiting the extent to which the effect of TPE alone can be judged. Information that complies with the guidelines modifies knowledge and inappropriate beliefs. Whether formalized or not, TPE appears to modify (i) the physical disability and pain related to LBP and (ii) the patient's choice of therapy (e.g. surgery). The impact appears to be more marked in the (sub)acute phases.

Discussion: National and international guidelines suggest that TPE based on a biopsychosocial model has a positive impact on the patients' behaviour and treatment compliance. The cost/benefit ratio appears to be favourable.

Conclusion: Therapeutic patient education appears to reduce the negative consequences of fear-avoidance behaviour and thus promotes treatment compliance in LBP patients, from the acute phase onwards.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Acute Disease
  • Chronic Disease
  • Cost-Benefit Analysis
  • Diskectomy
  • France
  • Health Knowledge, Attitudes, Practice
  • Health Services Needs and Demand
  • Humans
  • Low Back Pain / economics
  • Low Back Pain / psychology
  • Low Back Pain / rehabilitation*
  • Low Back Pain / surgery
  • Low Back Pain / therapy
  • Models, Psychological
  • Patient Compliance
  • Patient Education as Topic* / economics
  • Postoperative Complications / rehabilitation
  • Practice Guidelines as Topic*
  • Subacute Care
  • Teaching Materials / economics