Effects of Therapeutic Neuroscience Education in Patients With Chronic Low Back Pain
Condition: Chronic Low-back Pain
MeSH terms: Back Pain; Low Back Pain
Study type: Interventional

Summary: 
      The study will be Randomized controlled trail, Subject diagnosed with low back pain meeting
      predetermined inclusion and exclusion criteria will be divided into two groups.

      Pre assessment will be done using pain and disability as subjective measurement through
      Numeric pain rating scale (NPRS) & modified Oswestry disability index and the lumber range by
      goniometer as objective measurement. One group is subject will be treated with therapeutic
      neuroscience education and core stability exercise and second group is core stability
      exercise. Each subject received 18 sessions with 3 treatments per week. Post treatment values
      recorded after the session.After data collection from defined study setting,data will be
      entered and analyzed at Riphah International University,Lahore
    

Detailed description: 
      Chronic low back pain (LBP) is very common musculoskeletal disorders and leading causes of
      disability worldwide. Numerous epidemiological data show that 11%-84% of people experience,
      have experienced,or will experience pain in the lower spine at least once in their lives .
      With a global prevalence of 9.4%, LBP was ranked highest in the number of years lived with a
      disability and sixth in overall burden of disease Pakistan can suffer 56% from the LBP
      Nociplastic pain can be mechanistically defined as pain arising from the altered function of
      pain-related sensory pathways in the periphery and CNS, causing increased sensitivity
      Nociplastic pain should be viewed as an overarching terminology that can be applied to a
      diverse range of clinical conditions that share common neurophysiological mechanisms.

      The main concern of TNE concept is that increasing the patient feeling of biology and
      physiology underpinning their pain condition instead of focus on anatomy and structure issues
      of tissue.In order to improve health of patient with CLBP healthcare provider proper educate
      their patient about experiencing pain and it may not result of tissue damage Several non
      surgical treatments have been offered to help and decrease LBP, such as joint manipulation,
      traditional therapeutic exercises , and medication

      core stability training (CST) program this type of exercise focuses on the ability of the
      spine to stabilize in different positions and emphasize smaller, deeper, and posterior
      muscles. By increasing the endurance of these muscles, they retrain and maintain the correct
      physical condition to stabilize the spine to improve pain, performance, and ROM

      There are few studies in literature which compare the TNE effect with core stability
      exercisein CLBP however there have been no studies which can compare TNE with nociplastic
      pain which effects on CLBP
    

Intervention name(s): TNE; core stability
Intervention type(s): Other; Other
Intervention description(s): McGill exercise focuses on the ability of the spine to stabilize in different positions 3 sets of 3 repletion with of each of muscle and briefly explains the patient about their pain; McGill exercises for the low back.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: blinding
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: back pain; therapuetic neuroscience education; range of motion