Effectiveness of Pain Neuroscience Education Combined with Exercise in Non-Specific Low Back Pain: A Randomized Controlled Trial

Background: Non Specific low back pain (NSLBP) is a complex biopsychosocial condition often requiring integrated rehabilitation approaches(1). Pain Neuroscience Education (PNE), when combined with exercise therapy, may enhance outcomes by addressing central sensitization and pain catastrophizing(2). This study evaluates the efficacy of adding PNE to standard exercise therapy using a randomized controlled design.
Methods: Eighty adults with NSLBP were randomly allocated into two groups: Group A (Exercise only, n=40) and Group B (PNE + Exercise, n=40). Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores were measured at baseline and after 12 weeks. Between-group comparisons were conducted using independent t-tests. Effect sizes (Cohen’s d) were calculated, and assumptions for normality and homogeneity of variances were tested.
Results: Groups were statistically comparable at baseline (p>0.7). At 12 weeks, Group B exhibited significantly greater reductions in pain and disability scores (VAS mean difference: -1.8, 95% CI [-2.4, -1.2], p<0.001, d=1.4; ODI mean difference: -10.7, 95% CI [-13.3, -8.1], p<0.001, d=1.2).
Conclusion: PNE combined with exercise is superior to exercise alone in reducing pain and disability in patients with NSLBP over 12 weeks.