Effectiveness of Pain Neuroscience Education (PNE) to Veterans With Post-Traumatic Stress and Low Back Pain

Effectiveness of Pain Neuroscience Education (PNE) to Veterans With Post-Traumatic Stress and Low Back Pain

This trial compared traditional pain and stress education plus physical therapy to pain neuroscience education plus physical therapy in individuals with post-traumatic stress and chronic low back pain.

Veterans and Service Members with low back pain (LBP) will be recruited for this research. Once Veterans consent to participate in this research, participants will undergo baseline testing. Next, participants will randomly be assigned to one of two types of education: pain neuroscience education or traditional biomedical education. Each Veteran will receive 30 minutes of interactive education once a week for 4 weeks, depending on their group assignment. Following each education session, Veterans will participate in an exercise class that will last approximately 30 minutes. After the 4 week intervention, Veterans will complete the same questionnaires and measures as at the beginning of the program. Veterans will also complete subjective questionnaires at 8 weeks. Finally, healthcare utilization will be measured for 12 months following the research intervention.

Inclusion Criteria:

• Pain located between the 12th rib and buttocks that in the opinion of the screening examiner is originating from the lumbar region
• Current episode of back pain duration of 3 months or longer
• Active duty military or Veteran
• Read and speak English well enough to provide informed consent and follow study instructions

Exclusion Criteria:

• History of prior surgery to the lumbosacral spine within the previous 12 months
• Presence of neurogenic LBP defined by a positive contralateral straight leg raise (reproduction of symptoms below 45 degrees) or reflex, sensation, or strength deficits in a pattern consistent with nerve root compression
• Medical "red flags" of a potentially serious condition including cauda equina syndrome, major or rapidly progressing neurological deficit, fracture, cancer, infection, or systemic disease
• Discharged from physical therapy within the past 3 months for lower back pain
• Current diagnosis of psychotic conditions or medications (bi-polar, schizophrenia, personality disorder).
• Substance abuse or psychosis within 6 months of research.
• Unable to discontinue other active therapies until completion of clinical trial follow-up (8 weeks).
• Suicidal ideation
• Current pregnancy