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Therapeutic Exercise Plus Pain Neuroscience Education for Chronic Low Back Pain
Sponsor: Qingdao Municipal Hospital
Summary
\### What is this study about? This study looked at whether adding \*\*pain neuroscience education (PNE)\*\* to standard therapeutic exercise helps people with chronic low back pain who are afraid of moving (a condition called \*kinesiophobia\*). \### Why does it matter? Chronic low back pain is the leading cause of disability worldwide. Many people with chronic back pain develop fear of movement, which makes them avoid exercise and can slow down recovery. While exercise is the recommended first-line treatment, fear of movement often reduces how much patients benefit from it. Pain neuroscience education is a talking therapy that helps patients understand that chronic pain is not always a sign of tissue damage - it often involves the nervous system becoming overly sensitive. The idea is that changing how patients think about pain may reduce their fear and help them engage more fully in exercise. \### What did the researchers do? Patients with chronic low back pain and high fear of movement were randomly assigned to two groups * \*\*Group 1:\*\* 8 weeks of therapeutic exercise alone * \*\*Group 2:\*\* 8 weeks of therapeutic exercise \*\*plus\*\* two pain neuroscience education sessions (at the start and at week 4) * Patients were assessed at \*\*baseline, 8 weeks, and 24 weeks\*\* (6-month follow-up) * Measures included: fear of movement (TSK-17), pain intensity (NRS), disability (RMDQ), pain catastrophizing (PCS), and central sensitization symptoms (CSI) * Brain scans (resting-state fMRI) were taken before and after the intervention to explore potential brain-behavior links
Official title: Adjunct Pain Neuroscience Education for Kinesiophobia in Chronic Low Back Pain: a Randomized Controlled Trial With Exploratory Resting-state fMRI
Key Details
Gender
All
Age Range
18 Years - 65 Years
Study Type
INTERVENTIONAL
Enrollment
60
Start Date
2025-01-06
Completion Date
2025-10-15
Last Updated
2026-10-05
Healthy Volunteers
No
Conditions
Interventions
Therapeutic exercise
\*\*Therapeutic Exercise (TE)\*\* is a structured, supervised program of physical activities designed to improve strength, flexibility, motor control, and functional capacity in patients with musculoskeletal conditions such as chronic low back pain. In this study, the TE program combined three components: motor control exercises (e.g., transversus abdominis and multifidus activation to stabilize the lumbar spine), stretching exercises (e.g., piriformis and erector spinae stretches), and low-intensity aerobic training (daily walking). It was delivered in two supervised face-to-face sessions (at baseline and week 4) with prescribed home exercises performed twice daily, and served as the active control condition that both study groups received-with the experimental group additionally receiving pain neuroscience education.
Pain Neuroscience Education
\*\*Pain Neuroscience Education (PNE)\*\* is a non-pharmacological, educational intervention that helps people with chronic pain reconceptualize their understanding of pain. Through structured discussions and visual materials, a trained therapist explains that chronic pain is often not a reliable sign of ongoing tissue damage but rather a result of heightened nervous system sensitivity, and that psychological factors such as fear, stress, and negative beliefs can amplify pain perception. The goal is to correct misconceptions about pain, reduce fear of movement (kinesiophobia), and encourage patients to engage more fully in exercise and rehabilitation-rather than directly treating pain through manual therapy, medication, or exercise itself.
Locations (1)
Qingdao Municipal Hospital
Qingdao, Shandong, China