Pain Neuroscience Education for Depression
Condition: Chronic Low-back Pain; Depression
MeSH terms: Back Pain; Low Back Pain; Depression; Depressive Disorder
Study type: Interventional

Summary: 
      This study will look at the effects of Pain Neuroscience Education on a Depression outcome
      tool in patients with chronic low back pain.
    

Detailed description: 
      Pain and depression have been shown to be interrelated, especially chronic pain: people in
      chronic pain develop depression and people with depression develop chronic pain. In light of
      this coexistence it is not surprising that current best-evidence for depression and chronic
      pain shows significant overlap which includes primarily some type of cognitive intervention,
      aerobic exercise, and skilled delivery of medication including
      selective-serotonin-reuptake-inhibitors and/or membrane stabilizers. Current best-evidence
      regarding musculoskeletal pain provides strong support for Pain Neuroscience Education (PNE)
      to positively influence pain ratings, dysfunction, and limitations in movement, pain
      knowledge and healthcare utilization. Additionally, PNE has shown to powerfully influence
      psychosocial issues that powerfully influence pain and depression: fear-avoidance and pain
      catastrophization. Evidence is lacking in whether PNE could also influence depression
      ratings. The purpose of this study is to examine the immediate effect of PNE on pain,
      function, and depressive symptoms (using the Patient Health Questionnaire - PHQ-9) in
      patients attending PT for chronic low back pain (LBP).

      This will be a pre- and post-intervention convenience sample of consecutive patients with
      chronic LBP (pain > 6 months) meeting the inclusion criteria, attending outpatient PT. On
      initial examination, intake data and information will be collected prior to PNE and
      immediately following PNE.
    

Intervention name(s): PNE edcuation
Intervention type(s): Other
Intervention description(s): The PNE session will last 30 minutes and will be delivered in a one-on-one educational format with a clinician using prepared images, drawings and metaphors. The 30-minute PNE session was chosen to reflect a clinically meaningful intervention in a typical allocated time frame in clinical practice. The content of the PNE is described in detail elsewhere, using a metaphors to explain various aspects of pain including sensitization of the peripheral and central nervous system (sensitive alarm system metaphor); spreading pain (nosy neighbors metaphor); increases problems with focus and concentration (brain meeting metaphor) and difficulty with fatigue and sleep (lion metaphor).
Intervention model: Single Group Assignment
Intervention model description: This will be a pre- and post-intervention convenience sample of consecutive patients with chronic LBP (pain > 6 months) meeting the inclusion criteria, attending outpatient PT. On initial examination, intake data and information will be collected prior to PNE and immediately following PNE.
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: chronic; Low-Back Pain; Depression