Musings – June

Pre-Operative Pain Neuroscience Education for Lumbar Radiculopathy: A Multicentre Randomised Controlled Trial with One Year Follow-up, Louw et al, Spine 2014, May 28

67 patients from United States centres were studies. Half had usual care and half, in addition, were randomised to have one session of neuro-education delivered by a physical therapist and provision of a neuroscience education booklet. At the one year mark, there was no difference in residual pain percentages but the neuro-education group had 45% less health care expenditure compared to the control group.

Comment: This is a seminal paper that should change practice. An extremely inexpensive add-on therapy (limited neuroscience education) leads to almost a halving of health care expenditure in the twelve months post-surgery. This is something that can be relatively easily introduced both in public and private practice. This paper should be mandatory reading for all heads of hospital departments and managers.