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

Study Overview
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Brief Summary
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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).

Detailed Description
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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.

Official Title
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Pain Neuroscience Education for Acute and Sub-Acute Low Back Pain: An Exploratory Case Series

Conditions
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Low Back Pain, Pain, Chronic, Pain, Back

Intervention / Treatment
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* Behavioral: Pain Neuroscience Education


Participation Criteria
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Eligibility Criteria
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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.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Interventional Model Description: Observational cohort
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Pain Neuroscience Education<br>Subjects received a 15-minute verbal, one-on-one Pain Neuroscience Education (PNE) session | Behavioral: Pain Neuroscience Education<br>* 15 minute verbal one-on-one education session<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| NPRS - LBP | Numeric Pain Rating Scale for Low Back Pain (Range 0 = no pain to 11 = maximum pain) | Immediate change from baseline after assigned intervention | 
| NPRS - Leg pain | Numeric Pain Rating Scale for leg pain (Range 0 = no pain to 11 = maximum pain) | Immediate change from baseline after assigned intervention | 

Secondary Outcome Measures

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