The Effect of Secondary Prevention in Patients With Recurrent Low Back Pain

The Effect of Secondary Prevention for Low Back Pain by Means of Pain Education and Exercise Therapy in Patients With Recurrent Low Back Pain

This study investigates the effect of a secondary intervention program for low back pain in patients with recurrent low back pain. One third of the subject will receive no therapy, one third wil receive 2 sessions of pain neuroscience education (PNE) and one third will receive two sessions of PNE and 5 sessions of exercise therapy over 6 weeks.

Participants:

60 individuals with recurrent non-specific LBP were recruited through advertisement in sport facilities, social media and among friends and family.

Testing:

The testing was performed before and after a six week period by three blinded 2nd master students of physiotherapy of University of Ghent. The pre and post testing were almost identical and lasted 1 hour, only for the first testing an anamnesis was conducted to evaluate inclusion and exclusion criteria. The identical parts were tests for motor control, muscle performance and psychosocial factors.

Intervention:

The subjects were divided into 3 groups, only group B and C were given treatment. Group B had 2 sessions PNE over a period of two weeks. Group C received 2 sessions of PNE and 5 sessions of exercise therapy over a period of six weeks. Each of the sessions lasted 30 minutes and took place at the clinical practice room at the university of Ghent. Group C began the exercise therapy a week after the second session of PNE.

Inclusion Criteria:

• In remission during testing
• recurrent low back pain (RLBP) >6months
• 2 or more episodes in the past year
• Pain flare of ≥24 hours, characterized by an increase of ≥2 on an Numeric Rating Scale (NRS) scale and/or ≥5 on the Roland Morris Disability Questionnaire
• Followed by a pain-free episode of ≥1 month, characterized by a 0/10 on an NRS scale and/or <2 on the Roland Morris Disability Questionnaire
• Non-specific RLBP (no cause for Low back pain (LBP); >3y post discus herniation)
• 1 year or more post-natal

Exclusion Criteria:

• Use of antidepressants or analgesics (except for NSAIDs or paracetamol), taken 2 weeks before the testing
• Neurologic, respiratory, circulatory, or severe orthopedic diseases
• Pregnancy
• Specific LBP causes
• A history of cognitive exercise therapy and/or specific motor control training
• current treatment or new therapies starting <6 weeks before baseline assessment