Short- and medium-term effects of a single session of pain neuroscience education on pain and psychological factors in patients with chronic low back pain. A single-blind randomized control trial

Review written by Dr Sandy Hilton info

Key Points

  1. Pain neuroscience education (PNE) at high doses (100 – 400 min) combined with exercise is recommended as a first line of treatment for chronic low back pain.
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BACKGROUND & OBJECTIVE

The majority of chronic low back pain (CLBP) occurs without a clear mechanism of injury. Central sensitization and nociceptive dysfunction are theoretical causes for chronic pain despite there being no way to measure this and no demonstration of it in humans (1).

Addressing the significance of psychosocial factors in the experience of pain is another direction of research and treatment. The predominance of current research is on a biopsychosocial approach with emphasis on pain self-management with pain neuroscience education (PNE) being the most prominent frame of reference (2). Despite the evidence against the effectiveness of Back Schools that focus on posture and avoidance, the biomedical approach continues to be taught.

The authors of this study explored the potential impact of adding a single session of PNE to an existing biomedical program for CLBP.

The majority of chronic low back pain occurs without a clear mechanism of injury.
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Managing clinician expectations and patient concerns about recovery can be optimized by blending exercise and pain neuroscience education.

METHODS

Single blinded, two-arm randomized controlled clinical trial where the evaluator was blinded to the intervention patients received. Subjects were enrolled in the Physiotherapy Back School (BS) and were invited to join the study, N = 121. The BS included 5

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