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Low Back Pain: The Importance of Patient Education

It’s been reported that educating the patient about their condition reduces unnecessary anxiety and fear, which in turn, allows a more swift resolution of their condition. The intensity of low back pain (LBP) can sometimes be so severe, the patient can hardly move without getting a sharp, knife-like pain that stops them in their tracks. When one experiences this kind of pain, it’s very easy to assume what’s causing this, “….must be lethal!” Or perhaps, “how can anything hurt this bad and not be cancer?” These types of thoughts can lead to unnecessary (and frankly, inappropriate) behavior including fear of activity (including work), anxiety, depression, and poor coping skills. In this regard, all LBP guidelines include the important recommendation of offering appropriate reassurance and advice through patient education as it is KEY to reducing this unnecessary fear and anxiety. This includes educating the patient as to what hurts them (anatomical tissue damage), why it hurts so badly (the inflammatory cycle), and what they can and should do to get out of the acute, painful stage as quickly as possible (“RICE” or Rest, Ice, Compress, Elevate).

Education is related to experience. Stop and think about how a child manages pain. When they fall down and skin their knees, the intensity of their crying can be deafening! It’s obvious the child’s the reaction is exaggerated, as exemplified by that blood curdling scream. The reason for this heightened reaction is due to their lack of experience or “knowledge” about this type of injury – they don’t realize the pain will dissipate with a few minutes and as a result, they over react. As we age, skinning our knees is more irritating mentally than it is painful – we look at it and after muttering a few words under our breath (which won’t be repeated here), we go about our daily routine, knowing fully well that it will hurt for a while and eventually get better. Studies have shown that people who have graduated from high school or college have a higher pain threshold than those who have not. This may be because, through learning about the body in science class, they understand the anatomy and physiology (structure and function) behind a cut on the skin. As a result, there is no overreaction, just a “reaction.”

So, when can this educational process start? The answer is simple – as soon as possible; and actually, before we become patients! A recent study published in the journal Spine found 8-year-old school children were capable of out-performing a similar aged “control” group that were not educated on management and prevention of low back pain. Tests were administered initially, at 15 days and at 98 days after beginning the education process. They used a comic book as the method to educate the 266 member group of 8-year-olds while a “control” group of 231 kids did not receive the comic book educational tool. Initially, the 2 groups scored similarly (about 73% correct answers for both groups). The comic book was given to the 266 kid group at day 8 and both groups were retested again at the 15 and 98 day time points. The results showed the group receiving the comic book education about LBP scored significantly higher at 15 days and retained that information up to 3 months later. Though no one will know if the educated kids will be less prone to develop chronic pain due to this gain of knowledge, the increased likelihood certainly exists.

The take home message is: use the internet and all other resources to learn as much as you can about your back condition.


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