Cited by 537Musculoskeletal pain and rehabilitationPain Management and TreatmentPain Mechanisms and Treatments

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A Randomized Controlled Trial of Intensive Neurophysiology Education in Chronic Low Back Pain

Moseley, G. Lorimer, Nicholas, Michael K., Hodges, Paul W.·2004·The Clinical Journal of Pain

DOI 10.1097/00002508-200409000-00007

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Abstract

OBJECTIVES: Cognitive-behavioral pain management programs typically achieve improvements in pain cognitions, disability, and physical performance. However, it is not known whether the neurophysiology education component of such programs contributes to these outcomes. In chronic low back pain patients, we investigated the effect of neurophysiology education on cognitions, disability, and physical performance. METHODS: This study was a blinded randomized controlled trial. Individual education sessions on neurophysiology of pain (experimental group) and back anatomy and physiology (control group) were conducted by trained physical therapist educators. Cognitions were evaluated using the Survey of Pain Attitudes (revised) (SOPA(R)), and the Pain Catastrophizing Scale (PCS). Behavioral measures included the Roland Morris Disability Questionnaire (RMDQ), and 3 physical performance tasks; (1) straight leg raise (SLR), (2) forward bending range, and (3) an abdominal "drawing-in" task, which provides a measure of voluntary activation of the deep abdominal muscles. Methodological checks evaluated non-specific effects of intervention. RESULTS: There was a significant treatment effect on the SOPA(R), PCS, SLR, and forward bending. There was a statistically significant effect on RMDQ; however, the size of this effect was small and probably not clinically meaningful. DISCUSSION: Education about pain neurophysiology changes pain cognitions and physical performance but is insufficient by itself to obtain a change in perceived disability. The results suggest that pain neurophysiology education, but not back school type education, should be included in a wider pain management approach.

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Authors: Moseley, G. L., Nicholas, M. K., & Hodges, P. W.
Affiliations: The University of Sydney (AU)
Corresponding author: Moseley, G. Lorimer
Hodges, Paul W.
ORCID: Moseley, G. Lorimer
Nicholas, Michael K.
Hodges, Paul W.
Venue: The Clinical Journal of Pain
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2004
Volume: 20
Issue: 5
Pages: 324-330
ISSN: 0749-8047 (ISSN-L)
DOI: 10.1097/00002508-200409000-00007
OpenAlex: W2078673653
Cited by: 537
References: 50
Citations by year: 2026: 16 · 2025: 23 · 2024: 36 · 2023: 32 · 2022: 24 · 2021: 50 · 2020: 45 · 2019: 31 · 2018: 34 · 2017: 31 · 2016: 40 · 2015: 34 · 2014: 18 · 2013: 20 · 2012: 16
FWCI: 2.30
Type: journal article
Language: en
Open access: closed
Locations: Clinical Journal of Pain (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
Keywords: neurophysiology education, chronic low back pain, pain-related cognitions, pain catastrophizing, pain attitudes, disability, physical performance, cognitive-behavioral pain management, physiotherapy education
MeSH terms: Adult, Analysis of Variance, Chronic Disease, Double-Blind Method, Female, Humans, Male, Middle Aged, Neurophysiology, Pain Measurement, Patient Education as Topic, Psychomotor Performance, Surveys and Questionnaires, Cognitive Behavioral Therapy, Low Back Pain

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A Randomized Controlled Trial of Intensive Neurophysiology Education in Chronic Low Back Pain

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