A Cochrane review «Individual patient education for low back pain»1 «Engers A, Jellema P, Wensing M, van der Windt DA, ...»1 included 24 studies with a total of 7 139 patients. 14 studies (58%) were of high quality. Individual patient education was compared with no intervention in 12 studies; with non-educational interventions in 11 studies; and with other individual educational interventions in eight studies. In seventeen studies, written educational materials were used. Three studies used pamphlets containing biopsychosocial information. Twelve trials made use of a variety of booklets. One study included a book and videotapes. Fourteen studies used oral individual education.
For patients with subacute LBP, there is strong evidence that an individual 2.5 hour oral educational session is more effective on return-to-work than no intervention. Educational interventions that were less intensive were not more effective than no intervention. There is strong evidence that individual education for patients with (sub)acute LBP is as effective as non-educational interventions on long-term pain and global improvement. For patients with chronic back pain, individual education is less effective for back pain-specific function when compared to more intensive interventions. Comparison of different types of individual education did not show significant differences.
Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in interventions and outcomes) and by possible reporting bias (only English, German and Dutch literature was searched, no efforts were undertaken to track down the results of unpublished studies).
Clinical comment: Simple patient education sessions of shorter duration or written information do not seem to be effective as a single treatment. However, as they may be considered harmless if they are evidence-based and up-to-date, there is no reason for not using oral and written education to support treatment.