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Back schools for the treatment of chronic low back pain: possibility of benefit but no convincing evidence after 47 years of research -- systematic review and meta-analysis
Straube S, Harden M, Schroder H, Arendacka B, Fan X, Moore RA, Friede T
Pain 2016 Oct;157(10):2160-2172
systematic review

Back schools are interventions that comprise exercise and education components. We aimed to systematically review the randomized controlled trial evidence on back schools for the treatment of chronic low back pain. By searching Medline, Embase, and Cochrane CENTRAL as well as bibliographies, we identified 31 studies for inclusion in our systematic review and 5 of these for inclusion in meta-analyses. Meta-analyses for pain scores and functional outcomes revealed statistical superiority of back schools versus no intervention for some comparisons but not others. No meta-analysis was feasible for the comparison of back schools versus other active treatments. Adverse events were poorly reported so that no reliable conclusions regarding the safety of back schools can be drawn, although some limited reassurance in this regard may be derived from the fact that few adverse events and no serious adverse events were reported in the back school groups in the studies that did report on safety. Overall, the evidence base for the use of back schools to treat chronic low back pain is weak; in nearly a half-century since back schools were first trialled, no unequivocal evidence of benefit has emerged.

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