OBJECTIVE: To assess the effectiveness of patient education with 'myths and facts' versus 'facts only' on recall of back pain information and fear-avoidance beliefs in patients with chronic low back pain (LBP). DESIGN: Randomized Study Within A Trial (SWAT). METHODS: 152 participants with chronic LBP were included. Participants allocated to the 'facts only' group received an information sheet with six low back pain facts, whereas those allocated to the 'myths and facts' group received the same information sheet, with each myth refuted by its respective fact. The primary outcome was 'correct recall' of back pain facts, and the secondary outcome was 'physical activity component' of the Fear-avoidance Avoidance Beliefs Questionnaire (FABQ-pa), two weeks after the provision of the information sheet. RESULTS: There was no evidence of a difference in the proportion of participants with correct recall between 'myths and facts' and 'facts only' groups (OR 0.98, 95% CI 0.48 to 1.99) and no significant difference in FABQ-pa mean scores between groups (-1.58, 95% CI -3.77 to 0.61). Sensitivity analyses adjusted for prognostic factors showed no difference in information recall but a larger difference in FABQ-pa score (-2.3, 95% CI -4.56 to -0.04). CONCLUSIONS: We found no overall difference in recall of back pain information for patients provided 'myths and facts' compared with 'facts only' and a slight reduction in fear-avoidance beliefs for physical activity using 'myths and facts' compared to 'facts only', but the meaningfulness of this result is uncertain.

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