Individual Education for Patients With Chronic Low Back Pain: Likely a Clinically Relevant Effect for Long-term Disability Compared to Noneducational Interventions. A Systematic Review With Meta-Analysis
Leonardo Piano, Paolo Audasso, Lorenzo Benzi, Adele Occhionero, Marco Trucco, Tiziano Innocenti, Raymond Ostelo, Alessandro Chiarotto
Abstract
OBJECTIVE: To assess the effectiveness of individual education for patients with chronic low back pain (CLBP), compared to no intervention, placebo, noneducational interventions, or other type of education. DESIGN: Intervention systematic review with meta-analysis of randomized controlled trials (RCTs). LITERATURE SEARCH: PubMed, CINAHL, PEDro, Embase, and Scopus (up to January 14, 2024); citation tracking in Web of Science, grey literature and reference lists of previous systematic reviews. STUDY SELECTION CRITERIA: We included RCTs that evaluated individual patient education interventions for adults with CLBP. DATA SYNTHESIS: Random-effects meta-analysis for clinically homogeneous RCTs. We assessed risk of bias using the Cochrane Risk of Bias 2.0, and applied the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to assess the certainty of evidence. RESULTS: We included 17 RCTs (n = 1893). There was moderate-certainty evidence that individual patient education had a clinically relevant effect compared to noneducational interventions on long-term disability (standardized mean difference, –0.23; 95% confidence interval [CI]: –1.13, 0.66). There was moderate-certainty evidence that individual patient education had no effect on short-term health-related quality of life compared to no intervention (mean difference, –0.003; 95% CI: –0.04, 0.04), and no effect on medium-term disability (SMD, 0.10; 95% CI: –0.37, 0.57) and long-term pain intensity (mean difference, –2.20; 95% CI: –14.43, 10.03) compared to noneducational interventions. CONCLUSION: Individual patient education provided a clinically relevant effect on long-term disability when compared to noneducational interventions. There were no other clinically relevant effects of individual patient education for CLBP. J Orthop Sports Phys Ther 2025;55(5):331-343. Epub 20 March 2025. doi:10.2519/jospt.2025.12794