Pain Neuroscience Education for Acute and Sub-Acute Low Back Pain

Overview

To determine if Pain Neuroscience Education (PNE) would result in positive clinical changes in patients presenting with acute or sub-acute low back pain (LBP).

Full Title of Study: “Pain Neuroscience Education for Acute and Sub-Acute Low Back Pain: An Exploratory Case Series”

Study Type

  • Study Type: Interventional
  • Study Design
    • Intervention Model: Single Group Assignment
    • Primary Purpose: Treatment
    • Masking: None (Open Label)
  • Study Primary Completion Date: July 30, 2018

Detailed Description

Background: Pain neuroscience education (PNE) has shown efficacy in treating chronic pain. Clinicians may believe PNE is not suitable for acute and sub-acute pain. Subgroupings of low back pain (LBP) imply some patients with LBP may respond favorably to PNE.

Objective: To determine if PNE would result in positive clinical changes in patients presenting with acute or sub-acute LBP.

Methods: Eighty consecutive patients with LBP < 3 months were enrolled in the study. Patients completed a demographics questionnaire, leg and LBP rating (Numeric Pain Rating Scale – NPRS), disability (Oswestry Disability Index), fear-avoidance (Fear-Avoidance Beliefs Questionnaire), pain catastrophization (Pain Catastrophization Scale), central sensitization (Central Sensitization Inventory), pain knowledge (Revised Neurophysiology of Pain Questionnaire), risk assessment (Keele STarT Back Screening Tool), active trunk flexion and straight leg raise (SLR). Patients received a 15-minute verbal, one-on-one PNE session, followed by repeat measurement of LBP and leg pain (NPRS), trunk flexion and SLR.

Interventions

  • Behavioral: Pain Neuroscience Education
    • 15 minute verbal one-on-one education session

Arms, Groups and Cohorts

  • Experimental: Pain Neuroscience Education
    • Subjects received a 15-minute verbal, one-on-one Pain Neuroscience Education (PNE) session

Clinical Trial Outcome Measures

Primary Measures

  • NPRS – LBP
    • Time Frame: Immediate change from baseline after assigned intervention
    • Numeric Pain Rating Scale for Low Back Pain (Range 0 = no pain to 11 = maximum pain)
  • NPRS – Leg pain
    • Time Frame: Immediate change from baseline after assigned intervention
    • Numeric Pain Rating Scale for leg pain (Range 0 = no pain to 11 = maximum pain)

Secondary Measures

  • Active trunk flexion
    • Time Frame: Immediate change from baseline in centimeters after assigned intervention
    • Active trunk flexion measured in centimeters from fingertips to floor
  • Passive Straight Leg Raise
    • Time Frame: Immediate change from baseline in angular degrees after assigned intervention
    • Range of hip flexion angle during passive straight leg raise test measured in degrees

Participating in This Clinical Trial

Inclusion Criteria

  • a complaint of LBP with or without leg pain less than 3 months, and
  • a willingness to participate

Exclusion Criteria

  • a) were under age 18 (minor);
  • b) had undergone lumbar surgery;
  • c) could not read or understand the English language;
  • d) presented with any cognitive deficits rendering them unsuitable for PNE (i.e., stroke, traumatic brain injury, etc.),
  • e) declined to participate or
  • f) presented with a medical etiology (red flag) associated with their LBP.

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • University of Nevada, Las Vegas
  • Collaborator
    • St. Ambrose University
  • Provider of Information About this Clinical Study
    • Principal Investigator: Emilio J Puentedura, PT, DPT, PhD, Project Coordinator – University of Nevada, Las Vegas
  • Overall Official(s)
    • Kevin Farrell, PhD, Principal Investigator, St. Ambrose University

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