Individual Patient Education for Managing Acute and/or Subacute Low Back Pain: Little Additional Benefit for Pain and Function Compared to Placebo. A Systematic Review With Meta-analysis of Randomized Controlled Trials

J Orthop Sports Phys Ther. 2022 Jul;52(7):432-445. doi: 10.2519/jospt.2022.10698. Epub 2022 May 18.


Objective: To evaluate the effects of individual patient education for managing acute and/or subacute low back pain (LBP), compared to no intervention/placebo education, noneducational interventions, or other type of education.

Design: Systematic review with meta-analysis of randomized trials.

Literature search: PubMed, CINAHL, PEDro, Embase, Scopus, and CENTRAL (up to September 30, 2020); reference lists of previous systematic reviews.

Study selection criteria: Randomized controlled trials (RCTs) evaluating individual education for patients with acute and/or subacute LBP.

Data synthesis: Random-effects meta-analysis for clinically homogeneous RCTs. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach.

Results: We included 13 RCTs. There was moderate certainty evidence that individual patient education was more effective than placebo education for pain at medium term (mean difference [MD], -0.79; 95% confidence interval [CI]: -1.52, -0.07) and physical function at short term (standardized mean difference [SMD], -0.25; 95% CI: -0.47, -0.02) and medium term (SMD, -0.26; 95% CI: -0.48, -0.04), but with no clinically relevant effects. There was low-to-moderate certainty evidence that individual patient education was superior to noneducational interventions on short-term quality of life (MD, -12.00; 95% CI: -20.05, -3.95) and medium-term sick leave (odds ratio = 0.32; 95% CI: 0.11, 0.88). We found no clinically relevant between-group effects for any other comparison (low-to-high certainty of evidence) at any follow-up.

Conclusion: One or 2 hours of individual patient education probably makes little to no difference in pain and functional outcomes compared with placebo for patients with acute and/or subacute LBP. Considering its effects on other outcomes (eg, reassurance) and patients' desire for information about their condition, it is reasonable to retain patient education as part of a first-line approach when managing acute and subacute LBP. J Orthop Sports Phys Ther 2022;52(7):432-445. Epub: 18 May 2022. doi:10.2519/jospt.2022.10698.

Keywords: low back/lumbar spine; pain; systematic review/meta-analysis.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Humans
  • Low Back Pain* / therapy
  • Patient Education as Topic
  • Quality of Life
  • Randomized Controlled Trials as Topic