# 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.

## Key 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.