[Back school - an update]

The aim of this paper is to present an update of the Back School concept including recent randomised controlled studies, systematic reviews and guidelines.

After definition and classification of the origins of the Back School concept, results of randomised controlled studies and systematic reviews within the framework of the Cochrane Collaboration Back Review Group are presented with their consequences with regard to German and International guidelines for the rehabilitation and prevention of low-back pain.

The Back School, integrated into a multidisciplinary programme, is effective in the rehabilitation and prevention of recurrent and chronic low-back pain. It is not effective for acute back problems when compared to other treatment modalities. There is moderate evidence suggesting that back schools in an occupational setting reduce pain and improve function and return to work status.

The classic structure of the Back School with information, back protection exercises and gymnastics can be practiced successfully for chronic low-back pain and in an occupational setting. Insurance companies should consider the low-cost technology. For children, adolescents and for older people with osteoporosis and lumbar spinal stenosis, a special age-orientated design of the Back School is necessary.