Joining forces – combining cognition-targeted motor control training with group or individual pain physiology education: a successful treatment for chronic low back pain
Moseley, G.L. (2003), J Man Manip Therap 11: 88-94.
Another one that’s short and sweet. I can’t access the full study, once again. And once again I say, I am poverty stricken, living well under the poverty line etc. Moseley is very wealthy, so maybe he could make his work accessible for free? This is something I’ve often questioned…when people like Moseley set themselves up to be the wonderful caring, compassionate people. The ‘best human’ he can be as he so often says on podcasts (quote the podcast) why doesn’t he give away the book to those of us living under the poverty line? Why??? Why doesn’t he offer some free treatment? He could easily do that. Imagine the impact he could have on people lives! If that were his intent. And also, his treatments would have to work, wouldn’t they? And they don’t. so…
Anyway, I’m getting snarky again. Cos I’m on the 3rd study listed as being evidence that pain education reduces pain, and there is NO evidence yet…
This one costs $62 USD for 48 hours access. That’s about $103 Aussie dollars. If I buy this, my kids and I won’t eat this week, so…
Onwards to the study…
Chronic unremittent low back pain (LBP) is characterised by cognitive barriers to treatment. Combining a motor control training approach with individualised education about pain physiology is effective in this group of patients. This randomized comparative trial (i) evaluates an approach to motor control acquisition and training that considers the complexities of the relationship between pain and motor output, and (ii) compares the efficacy and cost of individualized and group pain physiology education. After an “ongoing usual treatment” period, patients participated in a 4-week motor control and pain physiology education program. Patients received four one-hour individualized education sessions (IE) or one 4-hour group lecture (GE). Both groups reduced pain (numerical rating scale) and disability (Roland Morris Disability Questionnaire). IE showed bigger decreases, which were maintained at 12 months (P <0.05 for all). The combined motor control and education approach is effective. Although group education imparts a lesser effect, it may be more cost-efficient
Ok, so this time they get pain education AND motor control training. That’s exercise, right? FFS. Once again, the study means nothing, it does NOT separate out pain education in any way. AS I said, I see this ALL the time. Its an actual strategy. I have no idea why no one questions this, how people can accept this as ‘evidence’.
I am quite willing to bet everything I own (admittedly not exactly a lot) that if you removed the education part, the results would be the same. That exercise (motor control training) is doing the heavy lifting. Pun intended.
This one seems to have 23 citations. And its al the same people. Moseley himself, Adriaan Louw, and Nils. They are the bulk of the citations, each referencing each other and their own work. A perfect little echo chamber circle jerk. These people are on cahoots, supporting each others flawed research and crappy conclusions to give each other, and therefore themselves, more credibility. They are the ‘names’ in the pain education industry. And they all sell books and programs and seminars and webinars. They ALL have a lot of money riding on this. So they help each other out. Everyone wins!
Except people living with severe, daily pain.
I don’t know what else to say about this study. It does not show that pain education reduces pain and disability. And it doesn’t’ mention how many people were in the study, so again, hard to judge the validity of the conclusions that it does draw – i.e. That one-on-one pain education is preferable to group sessions.
It should be mandatory to have those details in the abstract. What use is an abstract that doesn’t tell you the size of the sample, nor the size of the effect they are purporting to have achieved? Hey, the people who got physio got a bit better! Woot!
Not exactly good information here. Not exactly good science. Not exactly ‘evidence’!
So both groups improved with combined physiotherapy and pain education. Great. Those who received individualised education improved more, so one-on-one sessions are superior. Cool. Don’t know how much they improved though, just have to trust Lorimer on that. And since he’s never bent the truth before, and he’s totally trustworthy, that’s totally cool.