Impact of education in patients undergoing physiotherapy for lower back pain: a level I systematic review and meta-analysis

Migliorini, Filippo; Maffulli, Nicola; Schäfer, Luise; Manocchio, Nicola; Bossa, Michela; Foti, Calogero; Betsch, Marcel; Kubach, Joshua

Abstract

Introduction: Lower back pain (LBP) is one of the most common musculoskeletal disorders in modern society, with a lifetime incidence of up to 90%. According to most national and international guidelines, educational interventions play a central role in the multimodal treatment of LBP. This systematic review and meta-analysis investigated the impact of educational interventions on pain and disability in patients with LBP undergoing physiotherapy compared to patients without educational interventions undergoing physiotherapy. Methods: In October 2024, a comprehensive computer-aided search was performed to assess the online databases PubMed, Web of Science, Google Scholar, and Embase. The search followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria with an established PICOTD algorithm. Two authors independently performed the data extraction and risk of bias evaluation. The primary outcome measures extracted were a pain score (VAS or NRS) and the Roland Morris Disability Questionnaire (RMQ). Results: Data from 8152 patients were retrieved. The mean length of follow-up was 6.2 ± 3.9 months, the mean length of symptom duration was 66.7 ± 51.6 months, and the mean age of the patients was 46.7 ± 9.2 years. Compared to physiotherapy alone, additional education did not reduce pain (P = 0.4) or disability according to the RMQ (P = 0.9). Conclusion: The addition of education did not impact pain and disability in patients undergoing physiotherapy for chronic non-specific LPB. Level of evidence: Level I, systematic review and meta-analysis of RCTs.

Citation

Migliorini, F., Maffulli, N., Schäfer, L., Manocchio, N., Bossa, M., Foti, C., Betsch, M., & Kubach, J. (in press). Impact of education in patients undergoing physiotherapy for lower back pain: a level I systematic review and meta-analysis. European Journal of Trauma and Emergency Surgery, 51(1), 1-19. https://doi.org/10.1007/s00068-025-02788-9

• Journal Article Type: Review
• Acceptance Date: Feb 2, 2025
• Online Publication Date: Feb 19, 2025
• Deposit Date: Feb 27, 2025
• Publicly Available Date: Feb 27, 2025
• Journal: European Journal of Trauma and Emergency Surgery
• Print ISSN: 1863-9933
• Electronic ISSN: 1863-9941
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 51
• Issue: 1
• Article Number: 113
• Pages: 1-19
• DOI: https://doi.org/10.1007/s00068-025-02788-9
• Keywords: Lower back pain, Spine, Physiotherapy, Education
• Public URL: https://keele-repository.worktribe.com/output/1078340