Pain neuroscience education with physical activity improves physical and psychological outcomes in older women with chronic low back pain

TL;DR

Teaching older women about pain science and encouraging physical activity improves both physical and mental health outcomes for those with chronic back pain.

Contribution

Pain Neuroscience Education combined with physical activity shows superior outcomes compared to traditional biomechanical treatments for older women with chronic low back pain.

Findings

PNE-PA improved physical function and step count significantly more than traditional treatments.

PNE-PA reduced pain catastrophizing and fear-avoidance beliefs more effectively.

Improvements were measured using intention-to-treat and bootstrap resampling methods.

Abstract

Chronic low back pain (CLBP) significantly impairs quality of life and increases mortality among older adults, making its effective management essential for healthy aging. This quasi-randomized trial compared Pain Neuroscience Education emphasizing physical activity (PNE-PA) with traditional biomechanical treatments (BM) in older women with CLBP over 12 weeks. Community-dwelling women aged 65–90 years with CLBP were assigned to either group based on recruitment timing, using a double-blinded design. PNE-PA aimed to reduce pain-related fear by educating patients about pain neuroscience and encouraging physical activity. Outcomes included physical function, pain intensity, self-reported disability and psychological factors. Analyses used intention-to-treat and bootstrap resampling methods. Between-group differences were assessed using mean differences, 95% confidence intervals (CI), and Cohen’s d. The PNE-PA group (n = 24) showed significantly greater improvements than the BM group (n = 18) in Chair Stand Test (95% CI: 1.53 to 7.76, d = 0.88), step count (95% CI: 475.97 to 2550.42, d = 0.87), pain catastrophizing (95% CI: -10.64 to -1.95, d = -0.87), and fear-avoidance beliefs (95% CI: -7.40 to -0.14, d = -0.65). These findings suggest that Pain Neuroscience Education emphasizing physical activity was associated with better physical and psychological outcomes among older women with chronic low back pain.

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