Chronic low back pain (CLBP) can really decrease a person's quality of life. There are many ways to approach the treatment of CLBP. Back school is one method that's been around since the late 1960s.
Back School is a prevention and education program to help patients understand and care for their backs. Information about anatomy, posture, lifting, and exercise is presented over a period of weeks to months. The goal is to raise patients' awareness of their own bodies and to increase their ability to function in everyday life. It's usually presented to a group of patients rather than on a one-on-one basis. Exercises are a part of the program.
In this study, the use of back school is evaluated in a group of women with CLBP. Two groups of women were compared. The first group received the back school program and medication. Meds included Tylenol (pain reliever), nonsteroidal antiinflammatory drugs (NSAIDs, pain reliever and antiinflammatory), and chlordiazepoxide (antidepressant). The second group just got the medications.
The main measure of results was quality of life (QOL). Women in both groups completed a survey of questions (SF-36) about physical and mental health. The questionnaire was completed before treatment and after treatment at three, six, and 12 months. QOL is reported using a score from zero (worst) to 100 (best).
The goal of this particular program was to help patients achieve the highest level of function possible. The program focused on empowering the women through education and self-awareness. Setting goals to improve quality of life was also included. A team approach was used. A PhD level educator, clinical psychologist, rheumatologist, and physiotherapist were all part of the process.
The authors report scores increased for both groups. But the Back School group had the most significant improvement. Most of the change occurred during the first three months of the program. Scores did not differ between six and 12 months. This may be because direct weekly communication was stopped after three months. Without the added encouragement and motivation, QOL measures didn't improve. They also didn't get worse. Scores just stayed the same over time.
A back school program worked better than meds alone for this group of women. The results of other studies suggest this is because QOL measures look beyond physical impairment. Function and psychologic well-being are also addressed.
Adding medications to a back school program may help patients perform daily activities. The risk of disability was less when the women used healthier body mechanics and exercised to improve strength and flexibility.
Sedigheh Sadar Tavafian, PhD, et al. A Randomized Study of Back School in Women With Chronic Low Back Pain. In Spine July 1, 2008. Vol. 33. No. 15. Pp. 1617-1621.
