Education for Chronic Lower Back Pain

Overseen By Alexandra Roybal, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Northwestern University

Disqualifiers: Specific diagnosis, Non-English speakers

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

Duration: 4-12 weeks

269 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how educational materials can help people with chronic lower back pain (LBP) better understand their condition. Participants will receive either a detailed presentation with slides explaining various causes of back pain and possible treatments or a shorter version for comparison. The goal is to determine if this information helps patients more accurately identify the causes of their back pain. Suitable participants have experienced LBP or sciatica for more than three months and can read English. As an unphased trial, this study offers participants the chance to contribute to valuable research that could enhance educational approaches for managing chronic back pain.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this educational intervention is safe for patients with chronic lower back pain?

Research has shown that learning about low back pain can be safe and helpful. One study found that when caregivers learned how to manage low back pain, their own pain levels decreased. This suggests that education can be a useful tool for those dealing with back pain.

Another study found that people often hold misconceptions about back pain, which can worsen their symptoms. Education can help correct these misconceptions and possibly lead to better outcomes.

Additionally, there are no reports of negative effects from educational programs about low back pain. Since education is neither a medicine nor a physical treatment, it typically doesn't cause physical side effects.

In short, structured education about your condition is a safe approach. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the educational approach for chronic lower back pain because it empowers patients with knowledge, potentially reducing reliance on medications and invasive procedures. Unlike conventional treatments like pain medications, physical therapy, or surgery, this method focuses on understanding pain management and prevention. By educating patients on the mechanisms of back pain, they can make informed lifestyle changes that may lead to long-term relief and improved quality of life. This proactive, non-invasive strategy marks a shift towards patient-centered care, which is why it holds significant promise.

What evidence suggests that this educational intervention is effective for chronic lower back pain?

This trial will compare an educational initiative on back pain with a control initiative. Research has shown that educational programs can help people with chronic lower back pain. Studies have found that teaching patients about their condition greatly reduces long-term disability compared to treatments without education. Learning about pain, especially when paired with physical activity, improves both physical and mental health for those with chronic lower back pain. Additionally, combining education with exercise or physical therapy leads to better overall improvement. These findings suggest that education is a valuable tool in managing chronic lower back pain. ^{6 7 8 9 10}

Are You a Good Fit for This Trial?

This trial is for individuals experiencing chronic low back pain who are visiting a doctor for the first time about this issue. Participants should be able to review educational material and communicate their thoughts on the cause of their pain.

Inclusion Criteria

I have had lower back pain for more than 3 months.

My main issue is lower back pain or sciatica.

I am older than 18 years.

Exclusion Criteria

Inability to understand written English

Referral for a specific diagnostic procedure or who present with a pre-established diagnosis

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Education and Diagnosis

Participants receive educational slides on back pain and self-diagnose their condition

1 day

1 visit (in-person)

Treatment

Participants receive treatments such as injections, medications, or physical therapy based on their diagnosis

4-12 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Control
• Education

Trial Overview

The study tests if patients can identify the source of their low back pain after reviewing an educational presentation with images and information. Their self-diagnosis will be compared to physicians' assessments.

How Is the Trial Designed?

Group I: Education Experimental Treatment 1 Intervention

Educational initiative on back pain

Group II: Control Active Control 1 Intervention

Control initiative (non-comprehensive overview)

Who Is Running the Clinical Trial?

Northwestern University

Lead Sponsor

Trials

1,674

Recruited

989,000+

Published Research Related to This Trial

Individual patient education for managing acute and subacute low back pain (LBP) showed moderate evidence of being more effective than placebo education in reducing pain and improving physical function, although the effects were not clinically significant.

The education was also found to improve short-term quality of life and reduce sick leave compared to noneducational interventions, suggesting that while the direct impact on pain may be minimal, patient education remains a valuable component of LBP management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

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. Piano, L., Ritorto, V., Vigna, I., et al.[2022]

A study involving 162 patients with low back pain found that a novel educational booklet significantly improved patients' beliefs about back pain and their functional outcomes, particularly in those with high fear-avoidance beliefs.

While the experimental booklet led to better beliefs and disability scores over time, it did not have a significant effect on pain levels, indicating that improving understanding and attitudes may be more beneficial than directly reducing pain.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Information and advice to patients with back pain can have a positive effect. A randomized controlled trial of a novel educational booklet in primary care. Burton, AK., Waddell, G., Tillotson, KM., et al.[2022]

In a study involving 152 participants with chronic low back pain, providing education with 'myths and facts' did not significantly improve recall of back pain information compared to 'facts only'.

While there was no overall difference in information recall, the 'myths and facts' approach showed a slight reduction in fear-avoidance beliefs related to physical activity, although the significance of this finding is uncertain.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

"Myths and Facts" Education Is Comparable to "Facts Only" for Recall of Back Pain Information but May Improve Fear-Avoidance Beliefs: An Embedded Randomized Trial. Viana da Silva, P., Kamper, SJ., Robson, E., et al.[2022]

In a randomized controlled trial involving 222 patients with nonspecific chronic low back pain, both education interventions (with and without therapeutic alliance) showed significant improvements in patient-specific disability compared to no education, but did not significantly reduce pain levels.

The study found no clinically relevant differences in outcomes between the education-only group and the education-plus-therapeutic alliance group, suggesting that the therapeutic alliance did not enhance the effectiveness of the educational intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Education With Therapeutic Alliance Did Not Improve Symptoms in Patients With Chronic Low Back Pain and Low Risk of Poor Prognosis Compared to Education Without Therapeutic Alliance: A Randomized Controlled Trial. Miyamoto, GC., Fagundes, FRC., de Melo do Espírito Santo, C., et al.[2021]

Education and advice for adults with chronic primary low back pain (CPLBP) led to significant improvements in pain, function, and health-related quality of life, based on a review of 15 randomized controlled trials involving various outcomes assessed 3 to 6 months post-intervention.

Despite these positive effects, the certainty of evidence was very low, indicating that while education/advice can be beneficial, further research is needed to confirm these findings and their effectiveness compared to other interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Systematic Review to Inform a World Health Organization (WHO) Clinical Practice Guideline: Benefits and Harms of Structured and Standardized Education or Advice for Chronic Primary low back pain in Adults. Southerst, D., Hincapié, CA., Yu, H., et al.[2023]

Patient education was once considered the most effective treatment for back pain in the 1970s and 1980s, but recent studies have shown that this view is overly simplistic.

Current evidence from randomized controlled trials and meta-analyses suggests that while education is important, it should not be the sole treatment for non-specific low back pain, indicating a need for a more comprehensive approach to management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Back pain: lessons from patient education. Nordin, M.[2019]

A cognitive patient education intervention for low back pain patients led to a faster improvement in their illness perceptions compared to usual care, as shown in a study involving 203 patients followed for up to 12 months.

While the intervention showed significant benefits for illness perceptions, it did not result in improvements in other psychological outcomes or quality of life measures, indicating the need for further research to explore its full impact.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of individualized quality of life and illness perceptions in low back pain. A patient education cluster randomized controlled trial. Løchting, I., Storheim, K., Werner, EL., et al.[2022]

Education programs aimed at preventing and treating low back pain (LBP) in Hispanic populations can significantly enhance usual care outcomes, particularly in reducing disability, as shown in a systematic review of nine randomized clinical trials.

Programs focusing on pain neurophysiology and active management were found to be more effective than traditional education methods, suggesting that these approaches should be prioritized in future studies for better LBP management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Efficacy and Effectiveness of Education for Preventing and Treating Non-Specific Low Back Pain in the Hispanic Cultural Setting: A Systematic Review. Kovacs, FM., Burgos-Alonso, N., Martín-Nogueras, AM., et al.[2022]

Educational pamphlets about back pain have been effective in changing knowledge and beliefs among individuals in a manufacturing setting, leading to reduced absenteeism from work.

While traditional back schools have had limited success in industry, pamphlet education appears to be a cost-efficient method for improving health behaviors related to back pain, warranting further research in various work environments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Back school or pamphlet education: which is best for industry? Symonds, T.[2014]

In a study involving 136 patients with Chronic Low Back Pain, those who participated in an educational program showed a significantly higher level of physical activity at three months (91% vs. 77% for the control group) and a lower dropout rate at six months (60% vs. 73%).

The results suggest that incorporating an educational component focused on motivation and physical activity into a multidisciplinary care plan can enhance patient adherence and support the maintenance of regular physical activity in CLBP patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Middle-term effects of education programme in chronic low back pain patients to an adherence to physical activity: A randomized controlled trial. Janik, F., Fabre, C., Seichepine, AL., et al.[2023]

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