The objective of this study was to assess the efficacy of a short education program and short physiotherapy program for treating low back pain (LBP) in primary care.Â Â Sixty-nine primary care physicians were randomly assigned to 3 groups and recruited 348 patients consulting for LBP; 265 (79.8%) were chronic. All patients received usual care, were given a booklet and received a consistent 15 minutes group talk on health education, which focused on healthy nutrition habits in the control group, and on active management for LBP in the “education” and “education + physiotherapy” groups. Additionally, in the “education + physiotherapy” group, patients were given a second booklet and a 15-minute group talk on postural hygiene, and 4 one-hour physiotherapy sessions of exercise and stretching which they were encouraged to keep practicing at home. The main outcome measure was improvement of LBP-related disability at 6 months. Patients’ assessment and data analyses were blinded. During the 6-month follow-up period, improvement in the “control” group was negligible. Additionalimprovement in the “education” and “education + physiotherapy” groups was found for disability, LBP, referred pain, catastrophizing, physical quality of life, and mental quality of life.
The addition of a short education program on active management to usual care in primary care leads to small but consistent improvements in disability, pain, and quality of life. The addition of a short physiotherapy program composed of education on postural hygiene and exercise intended to be continued at home, increases those improvements, although the magnitude of that increase is clinically irrelevant.
Albaladejo C, Kovacs FM, Royuela A, Del Pino R, Zamora J,. The Efficacy of a Short Education Program and a Short Physiotherapy Program for Treating Low Back Pain in Primary Care: A Cluster Randomized Trial. Spine. 2010 Feb 9 [EPub ahead of print].