Pain Education in the Management of Patients with Chronic Low Back Pain: A Systematic Review

Abstract

New prospective of chronic low back pain (CLBP) management based on the biopsychosocial model suggests the use of pain education, or neurophysiological pain education, to modify erroneous conceptions of disease and pain, often influenced by fear, anxiety and negative attitudes. The aim of the study is to highlight the evidence on the outcomes of a pain education-oriented approach for the management of CLBP. The search was conducted on the Pubmed, Scopus, Pedro and Cochrane Library databases, leading to 2673 results until September 2021. In total, 13 articles published in the last 10 years were selected as eligible. A total of 6 out of 13 studies support a significant reduction in symptoms in the medium term. Disability is investigated in only 11 of the selected studies, but 7 studies support a clear reduction in the medium-term disability index. It is difficult to assess the effectiveness of the treatments of pain education in patients affected by CLBP, due to the multimodality and heterogeneity of the treatments administered to the experimental group. In general, methods based on pain education or on cognitive-behavioral approaches, in association with physical therapy, appear to be superior to physiotherapeutic interventions alone in the medium term.