Effectiveness of Pain Neuroscience Education (PNE) to Veterans With Post-Traumatic Stress and Low Back Pain
Condition: Chronic Low Back Pain; Post-traumatic Stress
MeSH terms: Back Pain; Low Back Pain
Study type: Interventional

Summary: 
      This trial compared traditional pain and stress education plus physical therapy to pain
      neuroscience education plus physical therapy in individuals with post-traumatic stress and
      chronic low back pain.
    

Detailed description: 
      Veterans and Service Members with low back pain (LBP) will be recruited for this research.
      Once Veterans consent to participate in this research, participants will undergo baseline
      testing. Next, participants will randomly be assigned to one of two types of education: pain
      neuroscience education or traditional biomedical education. Each Veteran will receive 30
      minutes of interactive education once a week for 4 weeks, depending on their group
      assignment. Following each education session, Veterans will participate in an exercise class
      that will last approximately 30 minutes. After the 4 week intervention, Veterans will
      complete the same questionnaires and measures as at the beginning of the program. Veterans
      will also complete subjective questionnaires at 8 weeks. Finally, healthcare utilization will
      be measured for 12 months following the research intervention.
    

Intervention name(s): Pain Neuroscience Education; Exercise; Traditional Education
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): Weekly education sessions lasting approximately 30 minutes each, once a week for four weeks.
Session 1: the nervous system is like an alarm to protect.
Session 2: common ways the nervous system becomes sensitive.
Session 3: importance of gradual conditioning and neuroplasticity.
Session 4: common ways to decrease nervous system sensitivity.; The exercise protocol for each group will be identical and modeled after the "Back to Fitness" program. This program will consist of a 5-10-minute cardiovascular warm-up of walking in place or riding an exercise bike. Next is a 15-minute circuit consisting of 10 different general exercises for 1-minute each. Finally, a 5-minute cool down will consist of light stretching and trunk range of motion exercises. Each exercise will be tailored as easy, medium, or hard depending on the individual patient's tolerance. This program has been shown to be equally as effective as motor control exercises for long-term outcomes in patients with non-specific LBP.; Weekly education sessions lasting approximately 30 minutes each, once a week for four weeks.
Session 1 will include a basic overview of the anatomy of the spine.
Session 2 will discuss an overview of stress symptoms to include hypervigilance, avoidance, and re-experiencing.
Session 3 will cover common recommendations delivered in stress education: the do's and don'ts of stress management.
Session 4: review and mindfulness.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: chronic low back pain; post-traumatic stress; physical therapy; pain neuroscience education