Goal of the review?
In this review 1 the authors evaluate the effectiveness of advice/education of pain and disability in people with non-specific spinal pain. They also examine to what extent the characteristics of patients and interventions change the treatment effects.
Why are they doing this study?
Spinal pain is a leading cause of disability across the world. In Australia, the costs associated with chronic pain are predicted to increase from $139 billion to $215 billion by 2050. Despite the significant impact of chronic pain (spinal pain is the largest contributor), most systematic reviews are outdated and have missed critical studies and new research. Moreover, existing reviews have only looked at advice to stay active without analyzing advice on ergonomic changes or pain neuroscience education. For this reason, there continues to be much uncertainty on the effectiveness of guidance and education for the treatment of non-specific spinal pain.
What did they do?
The researchers did a systematic review with meta-analyses of randomized controlled trials. They included studies with participants who had non-specific spinal pain (back or neck) of any duration, interventions that focused on advice, education or information given by a healthcare professional. The review focused on two outcomes: pain and disability (primary) and adverse events (secondary).
What did they find?
In total, they included 27 trials with 7,006 participants. Most of the studies (18 in total) were assessed as being low risk of bias. Low-quality evidence from 18 trials indicated that advice had a negligible effect on pain in the short term. However, the advice provided almost no benefits at other time points. Meta-regression revealed no association between type of advice, duration of pain, location of pain, the intensity of treatment or mode of delivery with treatment effects. Moderate-quality evidence from 19 trials with 2579 participants indicated that advice had a small effect on disability in the short term, compared with no advice or placebo.
Why do these findings matter?
The findings suggest that advice provides some short-term improvements in pain and disability, but the effects are small and are not sufficient as the only treatment for patients with spinal pain.
At Dynamic Disc Designs, we believe our models can make a large difference when pain education is delivered. We look forward to future studies using ddd models as part of the patient education of pain.