Therapeutic Patient Education in Adults with Chronic Lower Limb Musculoskeletal Pain: A Scoping Review.

Background

Conservative treatment of chronic musculoskeletal pain includes exercise, manual therapy, medications, physical agents/modalities, and Therapeutic Patient Education (TPE). Research on TPE has predominantly focused on spinal pain, so we do not know the extent and scope of clinical research in other areas, particularly lower extremities. This review aimed to map current research on this topic.

Methods

We searched PubMed, PEDro, CINAHL, PsycINFO, and Cochrane Library up to 1 April 2024. We included RCTs on adults with chronic lower limb musculoskeletal pain, written in English, French, Spanish, or Italian.

Results

Fifty-two records concerning knee osteoarthritis (n.33), hip and knee osteoarthritis (n.8), hip osteoarthritis (n.3), chronic knee pain (n.3), patellofemoral pain (n.3), and gluteal tendinopathy (n.2) were included. TPE was delivered through self-management, disease-specific information, pain education, and the management of physical activity, load, diet, stress, and sleep. Interventions were both individual- and group-based; delivery methods included in-person intervention, telephone/video calls, and web tools/apps. TPE combined with exercise seemed to be more effective than exercise alone, information/little education, or usual care. The effects of TPE as a stand-alone intervention appeared uncertain.

Conclusions

There is considerable variability in TPE in terms of teaching topics, providers, administration methods, and dosage of interventions. Future studies should investigate the effects of TPE in young adult populations and in ankle conditions. They should also investigate the effects of TPE on pain intensity versus pain interference with activities, by deepening TPE effects on disability and quality of life.