The reassuring potential of spinal imaging results: development and testing of a brief, psycho-education intervention for patients attending secondary care



To develop and test a standardised method of interpreting spinal imaging findings in a manner designed to reassure patients with low back pain and promote engagement in an active recovery.


A five-phase development and testing process involved collaborative working party contributions, informal and formal appraisal of the intervention content by clinicians and consumers, a two-stage online evaluation of the take-home patient resource, and onsite testing.


A total of 12 health professionals and 77 consumers were included in formal evaluative processes at various stages of the development and testing process. Consumers assessed the revised iteration of the take-home resource to be clearer and easier to understand than the original version. We integrated all feedback and evaluation outcomes to develop the final intervention content, which was approved by experienced clinicians and considered safe. We devised a framework to guide delivery of the low-cost clinical intervention and a 10–15-min timeframe was demonstrated to be realistic.


We have developed, modified, and tested a pragmatic framework for a brief, psychoeducational intervention. We have established face validity and acceptability from key stakeholders and engaged clinicians and are ready to proceed with a pilot feasibility trial.

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Emma Karran is supported by the Royal Adelaide Hospital Clinical Research Grants (received 2014 & 2015) and the Royal Adelaide Hospital Research foundation Dawes Scholarship. G. Lorimer Moseley is supported by the NHMRC (Principal Research Fellowship ID: 1061279). GLM has received support from: Pfizer Australia, Kaiser Permanente, Results Physiotherapy, Agile Physiotherapy, Workers’ Compensation Boards in Australia, Europe and North America, the International Olympic Committee and Port Adelaide Football Club. He receives speaker fees for lectures on pain and rehabilitation. He receives royalties for books on pain and rehabilitation. The authors wish to acknowledge valuable contributions and cooperation of all who assisted with the stages described in this manuscript. In particular: Gavin Shepherd, Dave Moen, Yvonne Markey, Chronic Pain Australia, The Australian Pain Management Association, Spinal Clinic staff at the Royal Adelaide Hospital, patients and survey respondents.

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Correspondence to G. Lorimer Moseley.

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Karran, E.L., Yau, Y., Hillier, S.L. et al. The reassuring potential of spinal imaging results: development and testing of a brief, psycho-education intervention for patients attending secondary care. Eur Spine J 27, 101–108 (2018).

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  • Low back pain
  • Reassurance
  • Spinal imaging
  • Education
  • Intervention