Education in non-specific neck and low back pain: effective?
Education has long been used as part of a treatment or in attempt to prevent neck or low back pain. A recent meta-analysis concluded that education is ineffective, and not recommended in treating or preventing neck or low back pain. While at first hand, this looks like a big blow for the for the many clinicians promoting modern pain science to patients as an effective tool in the battle against chronic pain it is everything but. In a Letter to the Editor in “Manual Therapy”, it is highlighted that not all education is equal.
Many studies have shown that teaching patients about pain from a biomedical point of view - with focus on structures of the body, biomechanics, posture and protection the spine - has a tendency to have the opposite effect (nocebo) or no effect. We can harm our patients and it may be easier than you think. The beliefs we carry, transfer to our patients - and as most of us have had a biomedical education, we are at risk of imposing these beliefs to our patients through our assessment, treatment and our words. It is imperative to understand and acknowledge, that as health care professionals, we carry great responsibility for our patients and that we must update ourselves and embrace a biopsychosocial approach to pain.
We can change patient behavior and beliefs, and one powerful tool is education. For chronic pain, we need to shift our own and our patients’ focus from tissues to the brain and nervous system. It is time to embrace the complexity of pain.
> From: Hurley et al., Man Ther (2016) (Epub ahead of print). All rights reserved to Elsevier Ltd. Click here for the Pubmed summary.