Encyclopedia of Pain

2007 Edition


  • Geoffrey Harding
Reference work entry
DOI: https://doi.org/10.1007/978-3-540-29805-2_46


Reassurance and Activation


Activation and reassurance are interventions that have been used for the treatment of acute low back pain. They involve having the practitioner gain the patient’s confidence that they do not have a serious cause of pain, and that remaining active, or restoring activity, is beneficial for their recovery.


Systematic reviews have shown that bed rest is neither appropriate nor effective for acute low back pain (Koes and van den Hoogen 1994; Waddell et al. 1997). Bed rest offers no therapeutic advantages, and is less effective than alternative treatments in terms of rate of recovery, relief of pain, return to daily activities, and time lost from work. By inference, these results support keeping patients active.

Nevertheless, patients may harbour fears or misconceptions about their pain, which may inhibit their resumption of activities. Explanation and reassurance are required to overcome these fears.


The study of Indahl...

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  1. 1.
    Arborelius E, Bremberg S (1994) Prevention in Practice. How do General Practitioners Discuss Life-Style Issues with their Patients? Patient Educ Couns 23:23–31Google Scholar
  2. 2.
    Daltroy LH (1993) Consultations as Educational Experiences Doctor-Patient Communication in Rheumatological Disorders. Baillieres Clin Rheumatol 7:221–239Google Scholar
  3. 3.
    Indahl A, Velund L, Reikeraas O (1995) Good Prognosis for Low Back Pain when Left Untampered: A Randomized Clinical Trial. Spine 20:473–477Google Scholar
  4. 4.
    Indahl A, Haldorsen EH, Holm S et al. (1998) Five-Year Follow-Up Study of a Controlled Clinical Trial using Light Mobilization and an Informative Approach to Low Back Pain. Spine 23:2625–2630Google Scholar
  5. 5.
    Koes BW, Hoogen HMM van den (1994) Efficacy of Bed Rest and Orthoses of Low Back Pain. A Review of Randomized Clinical Trials. Eur J Phys Med Rehabil 4:96–99Google Scholar
  6. 6.
    Kurtz SM, Silverman JD, Benson J et al. (2005) Marrying content and process in clinical method teaching: enhancing the Calgary-Cambridge guides. Acad Med 78(8):802–9Google Scholar
  7. 7.
    McCracken LM, Evon D, Karapas ET (2002) Satisfaction with Treatment for Chronic Pain in a Specialty Service: Preliminary Prospective Results. Eur J Pain 6:387–393Google Scholar
  8. 8.
    McDonald IG, Daly J (2001) On Patient Judgement. Intern Med J 31:184–187Google Scholar
  9. 9.
    McGuirk B, King W, Govind J et al. (2001) The Safety, Efficacy, and Cost-Effectiveness of Evidence-Based Guidelines for the Management of Acute Low Back Pain in Primary Care. Spine 26:2615–2622Google Scholar
  10. 10.
    Miller WR, Rollnick S (2002) Motivational Interviewing: Preparing People for Change, 2nd edn. Guilford Press, New YorkGoogle Scholar
  11. 11.
    Roberts L, Little P, Chapman J et al. (2002) Practitioner-Supported Leaflets may Change Back Pain Behaviour. Spine 27:1821–1828Google Scholar
  12. 12.
    Waddell G, Feder G, Lewis M (1997) Systematic Reviews of Bed Rest and Advice to Stay Active for Acute Low Back Pain. Brit J Gen Pract 47:647–652Google Scholar
  13. 13.
    Watson P (1999) The MSM Quartet. Australasian Musculoskeletal Medicine 4:8–9Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2007

Authors and Affiliations

  • Geoffrey Harding
    • 1
  1. 1.SandgateQLDAustralia