Active Physical Therapy, Passive Physical Therapy and Pain Education for Chronic Pain: What the Evidence Shows

Physical therapists and physical therapist assistants who treat adults living with chronic low back pain or other persistent musculoskeletal pain and who want a clear account of what the current evidence says about active treatment, passive treatment and pain education.

Physical therapists and physical therapist assistants in outpatient orthopedics, primary care, hospital-based rehabilitation and community programs. Physical therapist assistants participate under the direction of the supervising physical therapist, who retains evaluation, diagnosis and plan-of-care decisions.

Intended audience

Physical Therapy

Level

Intermediate

Delivery format

Online, asynchronous, self-paced course: interactive reading with audio or video, and a scored post-test.

Based on

Di-Bonaventura S, Donado-Bermejo A, Matesanz-García L, Molina-Álvarez M, León-Hernández JV, Lizcano-Álvarez Á, Lerma-Lara S, Nogales-Morales M, Molina N, Fernández-Carnero J, Gurdiel-Álvarez F, Ferrer-Peña R. Effects of a pain oriented biobehavioral therapeutic education program on brain plasticity and pain intensity in subjects with chronic musculoskeletal pain: a feasibility study of a randomized controlled trial. Front Neurosci. 2025;19:1664158. doi:10.3389/fnins.2025.1664158

Baroncini A, Maffulli N, Manocchio N, Bossa M, Foti C, Schäfer L, Klimuch A, Migliorini F. Active and passive physical therapy in patients with chronic low-back pain: a level I Bayesian network meta-analysis. J Orthop Traumatol. 2025;26(1):66. doi:10.1186/s10195-025-00885-4

After completing this course, you will be able to:

1. Describe what the feasibility pilot of the pain-oriented biobehavioral education program reported for delivery, attendance and preliminary clinical outcomes in adults with chronic primary musculoskeletal pain.
2. State which category of physical therapy the Bayesian network meta-analysis reported as performing best for pain and disability in chronic mechanical or non-specific low back pain, and how certain its authors were about that ranking.
3. Distinguish what a feasibility design and a network meta-analysis can each support about active treatment, passive treatment and pain education, and name where the two papers leave the clinical question open.

1. Start Here: How This Course Works
2. Part One: Pain-Oriented Biobehavioral Education Added to Exercise in Chronic Musculoskeletal Pain
3. Who Took Part in the Education Feasibility Pilot
4. How the Education and Exercise Program Was Delivered
5. What the Feasibility Pilot Reported
6. What a Feasibility Design Can and Cannot Show
7. Part Two: Active Versus Passive Physical Therapy for Chronic Low Back Pain
8. The Trials and Patients Behind the Network Meta-Analysis
9. How Active, Passive and Combined Care Were Compared
10. What the Network Analysis Reported
11. Risk of Bias, Follow-Up Length and Other Limits
12. Bringing It Together
13. Where the Two Papers Agree
14. Where They Diverge and Which Paper Found What
15. Choosing Between Active Care, Passive Care and Education at the Treatment Table
16. What the Evidence Still Leaves Open
17. Key Takeaways
18. Post-Test and Course Evaluation

Quinn Millington, PT, DPT, ECS is the instructor of record: the licensed clinician who reviewed this course and signed off on it. The name and credentials print on the certificate.

Disclosures. This course was developed by The ConEd Solution, which has a financial interest in its sale. No outside funding or sponsorship was received. The instructor of record has no affiliation with the authors of the source publication or their institutions.

This course awards 1.0 contact hour (60 min). How you earn them:

1. Complete the course. Every lesson, in order.
2. Pass the post-test. Score 80% or higher. Retakes are allowed.
3. Complete the evaluation. A short form rating each learning objective and the course.
4. Download your certificate. It is issued on completion and stays available in My Account.

The episode time is its measured length. Reading, post-test and evaluation times are estimates.

This course is designed to satisfy the quality requirements state boards set for continuing education. Requirements vary by state, and confirming that a course fits your renewal is up to you. Each state’s own acceptance statement is in the credit panel on this page.

1. Di-Bonaventura S, Donado-Bermejo A, Matesanz-García L, Molina-Álvarez M, León-Hernández JV, Lizcano-Álvarez Á, Lerma-Lara S, Nogales-Morales M, Molina N, Fernández-Carnero J, Gurdiel-Álvarez F, Ferrer-Peña R. Effects of a pain oriented biobehavioral therapeutic education program on brain plasticity and pain intensity in subjects with chronic musculoskeletal pain: a feasibility study of a randomized controlled trial. Front Neurosci. 2025;19:1664158. doi:10.3389/fnins.2025.1664158
2. Baroncini A, Maffulli N, Manocchio N, Bossa M, Foti C, Schäfer L, Klimuch A, Migliorini F. Active and passive physical therapy in patients with chronic low-back pain: a level I Bayesian network meta-analysis. J Orthop Traumatol. 2025;26(1):66. doi:10.1186/s10195-025-00885-4