Background: Spinal pain is a leading cause of disease burden worldwide. It also is a major economic burden on society and the individual due to the costs of treatment, and work absence.
Aim/s: To determine the effectiveness of advice or education on pain and disability for people with non-specific spinal pain and to investigate potential treatment effect modifiers.
Methods: We searched multiple databases from their inception to September 2020 for randomised controlled trials comparing advice to no advice or placebo advice for adult populations with non-specific back and/or neck pain with or without radiating leg/arm pain of any duration were included. Trials recruiting pregnant women or surgical patients in the immediate post-operative phase were ineligible.
Results: We found 27 trials (n = 7006 participants). There was low-quality evidence that advice had a small effect on pain (MD -8.2, 95% CI: -12.5 to -3.9; n = 2241) and moderate-quality evidence that advice had a small effect on disability (MD -4.5, 95% CI -7.9 to -1.0, n = 2579) compared to no advice or placebo advice in the short-term. There were no significant modifiers of treatment effects.
Conclusions and Clinical Implications: Our results provide evidence that advice provides a short term benefit for non-specific spinal pain, but the effect is small and may not be sufficient as the sole treatment for patients with spinal pain.