A group of Danish researchers analysed 66 systematic reviews, guidelines, and consensus studies to create an overview of the current knowledge on patient education for chronic conditions such as low back pain, neck pain, and knee and hip osteoarthritis. The study, published in Chiropractic & Manual Therapies in 2026, paints a picture of a field with broad agreement that patient education is important, but far less clarity about what works, for whom, and why.
Clear, Relevant, and Targeted Information Is Essential
The clinical guidelines included in the review consistently recommend that patients with low back pain, neck pain, and knee and hip osteoarthritis should have access to information about their condition. The guidelines emphasize that such information must be clear, relevant, and tailored to the individual’s concerns, expectations, and circumstances. Education should help patients better understand their pain, dispel myths, foster realistic optimism, and provide tools for self-management. It typically also includes encouragement to engage in physical activity and gradually resume daily activities. Across diagnoses, patient education emerges as a fundamental component of the recommendations.
Uncertainty and Wide Variation in Research and Practice
The research base is marked by considerable uncertainty, despite the strong recommendations. The systematic reviews summarized in the article show that most studies on the effectiveness of patient education are either of low quality or demonstrate such large variability in methods and content that it is difficult to draw firm conclusions. Many studies examine different forms of education, such as “pain neuroscience education” (often described as an approach that helps patients develop a new understanding of pain by explaining how the nervous system works and what influences pain), or self-management–based programmes or educational interventions. In general, they show a positive effect, but no clear evidence that one approach is superior to another, and virtually no research explores individualized education, despite this being one of the aspects patients request most.
The study also shows that the dosage and format of education vary greatly. Some interventions consist of brief, standalone sessions lasting only minutes, while others extend over months and combine education with components such as exercise, counselling, or group discussions. The review reveals that when education is combined with physical activity or exercise, effects generally appear more favourable, whereas education alone produces more inconsistent results. Several reviews suggest that longer and more content-rich education may yield better outcomes than minimal interventions, but the findings are not consistent enough to draw firm conclusions. There is no evidence of a beneficial effect of minimal initiatives such as giving out a booklet etc.
Patients in Focus
A key contribution of the study is its synthesis of patients’ perspectives. Across qualitative studies, patients with chronic pain describe a clear need to be met with empathy, respect, and time to tell their story. Many patients report receiving contradictory or insufficient information and missing a coherent explanation of their pain, both in terms of biological mechanisms and the psychological and social factors influencing the pain experience. Patients do not merely want information; they want information that reflects their concerns, life situation, and hopes for the future. Education should create meaning and options for action, not just convey facts.
The researchers also identify a gap between recommendations and practice. Patients want individualized, dialogue-based courses of care, but effectiveness research focuses almost exclusively on standardized educational programs with fixed content. As a result, research lacks answers on how best to tailor education to the individual, and whether such tailoring may be crucial for effectiveness. The study also highlights the need for better descriptions of what education contains, as many existing reviews provide few details about what patients were taught.
Despite the uncertainty, the researchers agree on one point: Patient education should remain a central component of treating musculoskeletal disorders. But there is a need for new research that not only asks whether education works, but how it works, for whom, and how the content can best be conveyed. There is also a need for research that systematically measures patient knowledge.
A New Research Focus to Improve Patient Education
Overall, the mapping study shows a significant gap between what patients want and what research has examined so far. Patients want dialogue, individual guidance, and support in navigating both their pain and the healthcare system, but most studies still investigate fixed educational packages with uniform content. Consequently, research still lacks answers on how education can best be individualized—and whether this tailoring is key to improving effectiveness. The study also highlights the need for clearer descriptions of educational content, as existing reviews often fail to specify what was taught.
The researchers conclude that new research is needed—not only to test the content of education, but also its format, relational quality, and ability to be tailored to the individual. They particularly call for studies that examine which elements work for which patients—and why—as well as the development of more flexible educational approaches that can be integrated into clinical practice.
The question is no longer whether patient education works, but how it can be made more relevant, more individualized, and more effective? The study leaves both healthcare professionals and researchers with an important task: to develop and investigate patient education that takes greater account of patients’ needs and the complexity inherent in chronic pain.
A new mini book about back pain, aimed at patients with back pain and clinicians, based on the collective recommendations summed up in the study will be released in March 2026.
Alice Kongsted, Anders Christer Larsen, Mette Holz Meinhardt Gregersen, Tonny Elmose Andersen, Morten Høgh, Per Kjær, Anne Møller, Sophie Lykkegaard Ravn, Søren T. Skou, Jan Hartvigsen. Patient education for chronic musculoskeletal pain: a scoping review of recommendations, effectiveness, and educational content. Chiropractic & Manual Therapies 2026.
Would you like to know more?