Back Schools for chronic non-specific low back pain

Abstract

Due to the low- to very low-quality of the evidence for all treatment comparisons, outcomes, and follow-up periods investigated, it is uncertain if Back School is effective for chronic low back pain. Although the quality of the evidence was mostly very low, the results showed no difference or a trivial effect in favour of Back School. There are myriad potential variants on the Back School approach regarding the employment of different exercises and educational methods. While current evidence does not warrant their use, future variants on Back School may have different effects and will need to be studied in future RCTs and reviews.

Physical Therapy Approaches in the Treatment of Low Back Pain

“…Back schools use varying exercises and educational methods. There is very low-quality evidence that back school is more effective than no treatment (mean difference (MD) − 6.10, 95% confidence interval (CI) − 10.18 to − 2.01) in acute low back pain [ 21 ].…”

“…A recent Cochrane systematic review of RCTs evaluating the effectiveness of back schools was undertaken [ 21 ]. Low-quality evidence showed back schools to be no better than exercise in the intermediate-term (mean difference or MD − 4.46; 95% CI − 19.44 to 10.52), as well as at long-term follow-up (MD 4.58; 95% CI − 0.20 to 9.36) [ 21 ]. It remains unclear whether or not back schools are effective for chronic low back pain.…”

“…It remains unclear whether or not back schools are effective for chronic low back pain. At the long-term follow-up, very low-quality evidence showed passive physiotherapy to be better than back school (MD 9.60; 95% CI 3.65–15.54) [ 21 ].…”

Total disc replacement versus multidisciplinary rehabilitation in patients with chronic low back pain and degenerative discs: 8-year follow-up of a randomized controlled multicenter trial

“…However, many variations have evolved. A recent Cochrane review [151] reported generally very low quality of evidence for back schools, and found, at best, a trivial effect in the treatment of chronic LBP.…”

Patient education materials for non-specific low back pain and sciatica: a protocol for a systematic review and meta-analysis

“…Since this review, there have been additional systematic reviews that have assessed some form of patient education. [28][29][30][31][32][33][34][35][36][37][38][39][40] However, most of these reviews have investigated more intensive formats of education or skills training programmes (eg, multisession and multicomponent education programmes or self-management interventions), 28 30 32-37 or a specific delivery method of education (eg, verbal and communicative education strategies) 29 38 rather than the provision of education materials. Similarly, some reviews only focused on a specific education topic such as neurophysiological pain education.…”