Effects of Pain Neuroscience Education on Pain, Kinesiophobia in Patients With Non Specific Low Back Pain

NCT07460011 | Not Yet Recruiting DMC

• 1 other identifier: Dpt/ERB/49
• Study Type: interventional
• Target: 62
• Locations: 1 country
• Sites: 1

Brief Summary

Chronic non-specific low back pain (NSLBP) is a highly prevalent musculoskeletal condition and a leading cause of disability worldwide. Psychological factors such as fear-avoidance beliefs and kinesiophobia significantly contribute to pain chronicity, reduced physical activity, and functional limitations. Pain Neuroscience Education (PNE) is a biopsychosocial educational approach designed to reconceptualize pain as a protective output of the nervous system rather than solely a marker of tissue damage. This randomized controlled trial aims to determine the effect of Pain Neuroscience Education combined with Core Stabilization Exercises on pain intensity and kinesiophobia in patients with chronic non-specific low back pain. A total of 62 participants aged 20-55 years with mechanical low back pain lasting ≥3 months will be randomly allocated into two groups: (1) Core Stabilization Exercises plus PNE (experimental group) and (2) Core Stabilization Exercises alone (control group). The intervention duration will be four weeks, with three sessions per week. Primary outcomes include pain intensity measured by the Numeric Pain Rating Scale (NPRS) and kinesiophobia measured using the Fear-Avoidance Beliefs Questionnaire (FABQ). Assessments will be conducted at baseline and post-intervention. The study hypothesizes that the addition of PNE will produce greater reductions in fear-avoidance beliefs and pain intensity compared to exercise therapy alone.

Conditions

Non Specific Low Back Pain

Keywords

Pain; Kinesiophobia; Pain neuroscience education; Core stabilization; Numeric pain rating scale; Fear avoidance belief questionnaire

Outcome Measures

Primary Outcomes (1)

• Pain intensity

  The NPRS is an eleven-point pain scale that ranges from 0 to 10. On the scale, zero is labeled as "no pain at all" at the left end, and 10 is labeled as "worst possible pain" at the right end. As a result, larger values indicate more severe pain. The individual is asked to select an integer that best represents the severity of their pain. The NPRS is widely used for pain evaluation in clinical practice and research, with strong test-retest reliability and conceptual construct validity points.

  4weeks

Secondary Outcomes (1)

• Kinesiophobia

  4week

Study Arms (2)

Pain neuroscience education + core stabilization

EXPERIMENTAL

Participants receive core stabilization exercises combined with structured pain neuroscience education three times per week for four weeks

Other: Pain neuroscience education + core stabilization

Core stabilisation exercises only

ACTIVE COMPARATOR

Participants receive core stabilization exercises alone three times per week for four weeks without pain neuroscience education.

Other: Core stabilization exercises

Interventions

Core stabilization exercises OTHER

The control group participated in an exercise program which was founded on the principle of FITT. The participants attended 3 sessions a week in a span of four weeks. The sessions were 45 minutes long and occurred at an intermediate intensity, 10 reps per set. In the case of the intervention group, the hot pack application was applied to the area of pain followed by 10 minutes of trans-cutaneous electrical nerve stimulation (TENS) and maitland's grade I and II postero-anterior glide to manage pain. Subsequently, a structured core stabilization exercise program (bridging, bird- dog position, single knee-to-chest, curl-up, and side bridge exercises) was performed by participants

Core stabilisation exercises only

Pain neuroscience education + core stabilization OTHER

The intervention group met thrice a week in the course of four weeks as the FITT principle dictates. All sessions took 45 minutes and were moderate in their intensity with 10 repetitions per set. The initial treatment was a 10 minutes hot pack application and a 10 minutes trans-cutaneous electrical nerve stimulation (TENS). In addition to these modalities, participants engaged in an organized program of core stabilization exercises and maitland's grade I and II postero-anterior glide to manage pain. CSE included bridging, bird-dog position, single knee-to-chest, curl-ups, and side bridges. Parallel to the exercise component, a structured module of Pain Neuroscience Education (PNE) based on the biopsychosocial model was delivered weekly, focusing on the social, psychological, and physical dimensions of pain and functional recovery.

Pain neuroscience education + core stabilization

Eligibility Criteria

• Age: 20 Years - 55 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Participants included in this study were male and female patients aged between 20 and 55 years diagnosed with chronic non-specific low back pain of mechanical origin lasting three months or more.
• Individuals experiencing pain localized between the costal margin and gluteal folds without radiating symptoms or specific pathological causes were considered eligible.
• Participants with low back pain that has persisted for more than three months reported pain intensity of greater than three months.
• The study will involve those who have mechanical low back pain, which is defined as pain that is impacted by posture, movement, and physical activity but does not have a specific cause

You may not qualify if:

• Participants with a history of spinal fractures, previous spine injury, malignant tumors, spondylolisthesis, or spondylolysis were excluded from this study.
• The conditions associated with structural instability, neurological involvement, or serious underlying pathology.
• Individuals with a history of malignant tumors involving the spine were excluded because cancer-related pain.
• Pregnant women were also excluded from the study due to physiological, hormonal, and bio-mechanical changes that occur during pregnancy, which may alter spinal loading, pain perception, and movement patterns

Sponsors & Collaborators

• Lahore University of Biological and Applied Sciences: lead

Study Sites (1)

Ghurki trust and teaching hospital

Lahore, Pakistan

Location

MeSH Terms

Conditions

Pain; Kinesiophobia

Condition Hierarchy (Ancestors)

Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Phobic Disorders; Anxiety Disorders; Mental Disorders

Central Study Contacts

Maham Khalid

CONTACT

03334164339; mahamkhalid651@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: This study is conducted as a single-blinded randomized controlled trial in which participants are unaware of their group allocation to minimize performance bias. Due to the nature of the physiotherapy and educational interventions, the treating physiotherapist cannot be blinded. Outcome measures are recorded using standardized assessment tools to reduce assessment bias and maintain methodological rigor.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant professor

Model Details: This study uses a parallel assignment interventional model in which 62 participants with chronic non-specific low back pain are randomly allocated into two groups. The experimental group receives Core Stabilization Exercises combined with Pain Neuroscience Education, while the control group receives Core Stabilization Exercises alone. Both groups undergo treatment three times per week for four weeks and remain in their assigned groups throughout the study without crossover. The parallel design allows simultaneous comparison of the two interventions while preventing contamination or carryover effects. Outcomes are measured using the Numeric Pain Rating Scale (NPRS) and the Fear-Avoidance Beliefs Questionnaire (FABQ) at baseline and post-intervention.

Study Record Dates

• First Submitted: March 4, 2026
• First Posted: March 10, 2026
• Study Start: March 2, 2026
• Primary Completion (Estimated): September 2, 2026
• Study Completion (Estimated): September 2, 2026
• Last Updated: March 10, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)