Whole of community pain education for back pain. Why does first-line care get almost no attention and what exactly are we waiting for?
Abstract
A recent series of back pain articles in The Lancet 1–3 attracted a great deal of attention across the media, with the usual outrage at physios and doctors providing useless treatments, and the usual advice to sufferers to exercise and get psychological help. The authors—some of the most prolific back pain researchers on the planet—made a ‘call to action’ and it was a sensible one. But it was not really a new one—we have known for decades not to ‘ take back pain lying down ,’4 that the vast majority of back pain episodes do not require surgery or long-term powerful analgesics, and that most will resolve over time if we do not mess them up. So how is it that we are still in this mire of spiralling costs and widespread disability? When are we going to stop taking the very solid science and sensible calls to action just to see it mashed into an accusatory swing at doctors to clean up their act or sufferers to ‘get over it, change their mindset and exercise’? Back pain is not a simple problem. There are many forces at play 5 that propagate its widespread mismanagement. The massive elephant in the room—that entire professions appear to depend on the problem remaining unsolved—will be hard to tackle. In the meantime, the glaringly obvious cornerstone of best practice care that somehow keeps flying under the radar is education. Education is universally recommended as first-line treatment for acute and persistent back pain but it attracts little attention. Indeed, The Lancet papers1–3 clearly listed education of …
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Although education is almost universally recommended for LBP, there are no clear curricula for delivering it, and little attention is given to training, methods, settings or context.
“Although education is almost universally recommended for LBP, there are no clear curricula for delivering it, and little attention is given to training, methods, settings or context.13”
Cites
What low back pain is and why we need to pay attention
Hartvigsen, J., Hancock, M. J., Kongsted, A., Louw, Q., Ferreira, M. L., Genevay, S., Hoy, D., Karppinen, J., Pransky, G., Sieper, J., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(18)30480-x · Cited by 4,652 · see citing works
Prevention and treatment of low back pain: evidence, challenges, and promising directions
Foster, N. E., Anema, J. R., Cherkin, D., Chou, R., Cohen, S. P., Gross, D. P., Ferreira, P. H., Fritz, J. M., Koes, B. W., Peul, W., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(18)30489-6 · Cited by 2,398 · see citing works
Waddell, G. (2004) · Cited by 1,262 · see citing works
Low back pain: a call for action
Buchbinder, R., van Tulder, M., Öberg, B., Costa, L. M., Woolf, A., Schoene, M., Croft, P., Buchbinder, R., Hartvigsen, J., Cherkin, D., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(18)30488-4 · Cited by 1,242 · see citing works
Fifteen Years of Explaining Pain: The Past, Present, and Future
Moseley, G. L., & Butler, D. S. (2015) · The Journal of Pain · doi:10.1016/j.jpain.2015.05.005 · Cited by 856 · see citing works
Self-citationLouw, A., Zimney, K. J., Puentedura, E. J., & Diener, I. (2016) · Physiotherapy Theory and Practice · doi:10.1080/09593985.2016.1194646 · Cited by 738 · see citing works
Moseley, G. L. (2003) · Journal of Pain · doi:10.1016/s1526-5900(03)00488-7 · Cited by 530 · see citing works
Self-citationPopulation based intervention to change back pain beliefs and disability: three part evaluation
Buchbinder, R., Jolley, D., & Wyatt, M. (2001) · BMJ · doi:10.1136/bmj.322.7301.1516 · Cited by 426 · see citing works
Lee, H., McAuley, J. H., Hübscher, M., Kamper, S. J., Traeger, A. C., & Moseley, G. L. (2016) · Pain · doi:10.1097/j.pain.0000000000000472 · Cited by 87 · see citing works
Self-citationBagg, M. K., McAuley, J. H., Moseley, G. L., et al. (2018) · British Journal of Sports Medicine · doi:10.1136/bjsports-2017-098510 · Cited by 4 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Sharma, S., Jensen, M. P., Moseley, G. L., & Abbott, J. H. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-026874 · Cited by 61 · see citing works
Self-citation
- Authors
- Moseley, G. L.
- Affiliations
- University of South Australia (AU)
- Corresponding author
- Moseley, G Lorimer
- ORCID
- Moseley, G Lorimer
- Venue
- British Journal of Sports Medicine
- Publisher
- BMJ
- Published
- 2018-07-07
- Volume
- 53
- Issue
- 10
- Pages
- 588-589
- ISSN
- 0306-3674 (ISSN-L)
- 1473-0480
- OpenAlex
- W2847955111
- Cited by
- 27
- References
- 10
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 1 · 2023: 3 · 2022: 1 · 2021: 5 · 2020: 3 · 2019: 6 · 2018: 1
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- British Journal of Sports Medicine (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy-related medical research
- Keywords
- back pain, pain education, first-line care, patient education, back pain management, exercise therapy, psychological intervention, health care costs, disability
- MeSH terms
- Back Pain, Health Education, Health Personnel, Humans
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
