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Dr. Julia Alleyne, BHSc(PT), MD, CCFP, Dip. Sport Med MScCH,

Family Physician practising Sport and Exercise Medicine at the Toronto Rehabilitation Institute, University Health Network. She is appointed at the University of Toronto, Department of Family and Community Medicine as an Associate Clinical Professor.

CLINICAL TOOLS

Abstract: Back education or “Back Schools” are used both as a method of prevention and, in conjunction with traditional rehabilitation and exercise programs, as a component in treatment of recurrent or persistent low back pain. It is challenging to evaluate the effectiveness of this educational effort. Models have varied from brochures, booklets and simple office conversations to formal scheduled classes. Content has ranged from purely mechanical instruction to complex cognitive behavioural therapy. Essential to success is the ability to integrate the instructions into activities of daily living. The composition of those lessons remains the subject of continuing debate.
Key Words: Back School, education, body mechanics, prevention, pain management.

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Back education programs do not reduce the frequency or severity of future back pain attacks.
The educational message should be consistent, frequent and stress self-management.
Group education is useful but the message must be tailored to the individual.
Information must be integrated into the patient's daily routine.
Back education should be part of rehabilitation and is probably most effective during the sub-acute phase of recovery when the pain is still present but not so distracting that it prevents learning.
Comprehensive back school includes spinal anatomy, instruction in proper body mechanics, individualized pain control techniques plus the recognition and treatment of pain disorder through cognitive behavioural therapy when required.
The back program should follow the precepts of adult education with frequent interaction, problem solving, practical applications and a focus on participation.
A successful back school educates the patient about the benign nature of back pain and provides the tools to transfer knowledge about back hygiene into practice in the patient's life.
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