Advice and education for spinal pain

What is the effect of advice/ education on pain and disability compared with placebo or no advice/ education?

Spinal pain is a leading cause of disease burden and years lived with disability worldwide. Disability and costs associated with chronic pain (of which spinal pain is the largest contributor) are predicted to increase from $139 billion to $215 billion by 2050 in Australia.

International guidelines for the management of spinal pain endorse advice as part of first-line treatment. Recommendations from most contemporary guidelines include the provision of advice to remain active and avoid bed rest, advice on self-management, and reassurance of the good prognosis. However, there are also differences between guideilnes so at present the optimal content for patient advice is unclear. 

Although advice overall had a small or no effect on relieving pain and disability for non-specific spinal pain, the authors suggest that advice about prognosis and management options should remain part of the clinician/ patient interaction, because clinicians have a responsibility to ensure that their patients are adequately informed about their condition and patients typically want to know about their spinal pain.

It is also likely to have other benefits such as providing reassurance, which has been shown to reduce anxiety and health care use. Other treatments should be provided in addition to exercise/ advice.

> From: Jones et al., J Physiother 67 (2021) (Epub ahead of print). All rights reserved to Australian Physiotherapy Association. Click here for the online summary.

Want to read deeper into this topic? Have a look at the free full text version of this article published in Journal of Physiotherapy!

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