Information and Advice to Patients With Back Pain Can Have a Positive Effect

Burton, Kim; Waddell, Gordon; Tillotson, K. M.; Summerton, Nick

doi:10.1097/00007632-199912010-00010

Cited by 482 publications

(138 citation statements)

References 25 publications

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“…The current situation in Booklets are a simple, cheap, and popular method of providing health-related information to patients [30], and have been shown to be feasible and effective in low back pain [4,10]. More generally, studies have suggested that such material can improve compliance [15], alleviate anxiety and promote psychological well being [23], and reduce medical negligence claims [39].…”

Section: Discussionmentioning

confidence: 99%

“…This followed the general philosophy and style of The Back Book [56], which has been shown to be highly acceptable to health professionals and patients, and effective in changing patient beliefs and improving functional outcomes [4,10]. The main aim of the present booklet was to improve understanding, reduce uncertainty and anxiety, promote positive expectations and beliefs, and build confidence during post-operative recovery.…”

Section: Development Of the Bookletmentioning

confidence: 99%

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The development of an evidence-based patient booklet for patients undergoing lumbar discectomy and un-instrumented decompression

et al. 2006

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Post-operative management after lumbar surgery is inconsistent leading to uncertainty amongst surgeons and patients about post-operative restrictions, reactivation, and return to work. This study aimed to review the evidence on post-operative management, with a view to developing evidence-based messages for a patient booklet on post-operative management after lumbar discectomy or un-instrumented decompression. A systematic literature search produced a best-evidence synthesis of information and advice on post-operative restrictions, activation, rehabilitation, and expectations about outcomes. Evidence statements were extracted and developed into patient-centred messages for an educational booklet. The draft text was evaluated by peer and patient review. The literature review found little evidence for post-operative activity restrictions, and a strong case for an early active approach to postoperative management. The booklet was built around key messages derived from the literature review and aimed to reduce uncertainty, promote positive beliefs, encourage early reactivation, and provide practical advice on self-management. Feedback from the evaluations were favourable from both review groups, suggesting that this evidence-based approach to management is acceptable and it has clinical potential.

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Section: Discussionmentioning

confidence: 99%

Section: Development Of the Bookletmentioning

confidence: 99%

The development of an evidence-based patient booklet for patients undergoing lumbar discectomy and un-instrumented decompression

et al. 2006

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“…After the seminar, soldiers were involved in a question and answer session and issued The Back Book [27]. The Back Book was used as the educational supplement, because of our prior experience with it in a physical therapy clinical trial [12] and its prior association with positive shifts in patient LBP beliefs [8,10].…”

Section: Psychosocial Educational Program (Psep)mentioning

confidence: 99%

“…Psychosocial education that encourages positive coping was associated with decreased work absence in a quasi-experimental study [34]. The Back Book [27] is a pamphlet that delivers standard, evidencedbased information consistent with a biopsychosocial model, and has been used in randomized clinical trials demonstrating reduced disability and fear-avoidance beliefs in general practice [8] and physical therapy settings [12]. A quasi-experimental study also indicated that general practice patients given the Back Book reported higher patient satisfaction ratings and lower rates of persistent LBP [10].…”

Section: Introductionmentioning

confidence: 99%

Psychosocial education improves low back pain beliefs: results from a cluster randomized clinical trial (NCT00373009) in a primary prevention setting

George

Teyhen

et al. 2009

Eur Spine J

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The general population has a pessimistic view of low back pain (LBP), and evidence-based information has been used to positively influence LBP beliefs in previously reported mass media studies. However, there is a lack of randomized trials investigating whether LBP beliefs can be modified in primary prevention settings. This cluster randomized clinical trial investigated the effect of an evidence-based psychosocial educational program (PSEP) on LBP beliefs for soldiers completing military training. A military setting was selected for this clinical trial, because LBP is a common cause of soldier disability. Companies of soldiers (n = 3,792) were recruited, and cluster randomized to receive a PSEP or no education (control group, CG). The PSEP consisted of an interactive seminar, and soldiers were issued the Back Book for reference material. The primary outcome measure was the back beliefs questionnaire (BBQ), which assesses inevitable consequences of and ability to cope with LBP. The BBQ was administered before randomization and 12 weeks later. A linear mixed model was fitted for the BBQ at the 12-week follow-up, and a generalized linear mixed model was fitted for the dichotomous outcomes on BBQ change of greater than two points. Sensitivity analyses were performed to account for drop out. BBQ scores (potential range: 9-45) improved significantly from baseline of 25.6 ± 5.7 (mean ± SD) to 26.9 ± 6.2 for those receiving the PSEP, while there was a significant decline from 26.1 ± 5.7 to 25.6 ± 6.0 for those in the CG. The adjusted mean BBQ score at follow-up for those receiving the PSEP was 1.49 points higher than those in the CG (P \ 0.0001). The adjusted odds ratio of BBQ improvement of greater than two points for those receiving the PSEP was 1.51 (95% CI = 1.22-1.86) times that of those in the CG. BBQ improvement was also mildly associated with race and college education. Sensitivity analyses suggested minimal influence of drop out. In conclusion, soldiers that received the PSEP had an improvement in their beliefs related to the inevitable consequences of and ability to cope with LBP. This is the first randomized trial to show positive influence on LBP beliefs in a primary prevention setting, and these findings have potentially important public health implications for prevention of LBP.

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“…Accurate information should be given to the patient, as many myths and prejudices exist. 22 Once serious disease has been excluded, it should be explained to the patient that there is little likelihood of serious complications and that the term "simple back pain" is commonly used. Provide the patient with the most safe and effective methods of symptom control.…”

Section: Provision Of Patient Informationmentioning

confidence: 99%

The management of acute low back pain in adults: a guide for the primary care physician, Part II

Brighton

2013

South African Family Practice

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When a patient presents with acute low back pain (LBP), any red flag warnings of serious disease should first be excluded. Yellow and blue flag warnings of psychological factors should be noted. A psychological opinion of patients with substantial psychological distress could be sought. Advice may be offered on the benign nature of non-specific LBP. The person should be encouraged to be physically active and to continue with normal activities as far as possible. A structured exercise programme, that includes aerobic activity, movement instruction, muscle strengthening, postural control and stretching, should be devised. A combined exercise and psychological treatment programme that includes a cognitive behavioural approach can be considered in patients with significant disability or substantial psychological distress. A course of acupuncture may also be added. Manual therapy, including spinal manipulation, could be considered. Paracetamol should be the first medication option. If this is inadequate, a nonsteroidal anti-inflammatory drug or weak opioid, or both, can be added. Individual risks for side-effects and the patient's preference should be taken into account. Strong opioids should be considered in patients in severe pain, but for short-term use only. Antidepressants and gabapentine or pregabolin can be considered when there is a neurogenic component of the pain. Consider obtaining a surgical opinion on patients who have completed an optimal package of care and who still have persistent severe non-specific LBP. Progressive neurological fallout requires a surgical opinion.Peer reviewed.

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Information and Advice to Patients With Back Pain Can Have a Positive Effect

Cited by 482 publications

References 25 publications

The development of an evidence-based patient booklet for patients undergoing lumbar discectomy and un-instrumented decompression

The development of an evidence-based patient booklet for patients undergoing lumbar discectomy and un-instrumented decompression

Psychosocial education improves low back pain beliefs: results from a cluster randomized clinical trial (NCT00373009) in a primary prevention setting

The management of acute low back pain in adults: a guide for the primary care physician, Part II

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