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

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.

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.