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Low back pain education and short term quality of life: a randomized trial

Sedigheh Sadat Tavafian email, Ahmadreza Jamshidi email, Kazem Mohammad email and Ali Montazeri email

BMC Musculoskeletal Disorders 2007, 8:21doi:10.1186/1471-2474-8-21

Thanks for sharing your research findings!

Dorothy D. Zeviar, Ed.D., LAc   (29 March 2007)  Self-employed email

Hello,

Because in my practice I see many people with chronic low-back pain, including sciatica, I am especially grateful to you for writing up your very interesting research results and posting them for all healthcare practitioners to use.

It demonstrates to me that a little education on correct alignment, proper exercises, and walking each day can help people feel more self-empowered to control and even eliminate their back pain.

Additionally, I wish to add that "complementary" modalities such as acupuncture and Oriental Medicine are proven very effective in reducing the debilitation of back pain. In my practice, I combine electro-acupuncture, Chinese herbs, Tuina massage, dietary changes and exercise recommendations to reduce the incapacitation of low-back pain.

I hope your country can begin to include ancient complementary approaches (Oriental, Ayurvedic, Arabic, etc) with typical Western approaches to chronic low-back pain for the benefit of your clients.

Best wishes,

Dorothy D. Zeviar, Ed.D., LAc

Competing interests

I am a practicing licensed Acupuncturist and Oriental Medicine practitioner in Washington, USA.

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A question about the favorable outcome of group 1

Tom Shillock   (29 March 2007)  M2 Consulting email

Since the scoring of the intervention was done upon completion of the three month intervention, how can the authors be sure that responses were not due to some version of the Hawthorne effect? After all, the attention, information and support may have raised participants' expectations (hope) about reductions in pain and improvement in quality of life that skewed their assessments of their immediate post-intervention improvement? Wouldn't it be more meaningful to asses them at say six months or 12 months after termination of the intervention?

Competing interests

None.

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An answer to question about the favorable outcome of group 1

Ali Montazeri   (18 June 2007)  Iranian Institute for Health Sciences Research, Tehran, Iran email

Tom Shillock raises question that since the scoring of the intervention was done upon completion of the three month intervention, how can the authors be sure that responses were not due to some version of the Hawthorne effect? After all, the attention, information and support may have raised participants' expectations (hope) about reductions in pain and improvement in quality of life that skewed their assessments of their immediate post-intervention improvement? Then, Tom adds wouldn't it be more meaningful to asses them at say six months or 12 months after termination of the intervention?

We are grateful to Tom for raising a thoughtful question. However, this is to indicate that data for six and 12 months also were collected. The preliminary analysis showed that the group 1 (Back School group) had a better quality of life at 6 and 12 months follow-up as compared to the group 2 (clinic group). We hope to publish the results as soon as possible.

Competing interests

None

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