Effect of Pain Neuroscience Education and Physical Exercise for Patients with Lumbar Radiculopathy: A Randomized Clinical Trail
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Abstract
Background: Lumbar radiculopathy, characterized by pain that radiates from the lower back down to the leg, is a condition that significantly impacts the quality of life and functional ability of individuals. Recent studies have suggested the effectiveness of pain neuroscience education (PNE) in managing chronic pain conditions by enhancing patients' understanding of pain mechanisms. When combined with physical exercise, PNE has the potential to address both the physical and psychological aspects of lumbar radiculopathy.
Objective: The study aimed to evaluate the efficacy of combining pain neuroscience education with physical exercise in improving pain, functional ability, and fear-avoidance beliefs in patients with lumbar radiculopathy compared to physical exercise alone.
Methods: This randomized clinical trial included 34 participants diagnosed with lumbar radiculopathy. Participants were randomly allocated into two groups: the intervention group received PNE combined with physical exercise, while the control group received physical exercise only. The intervention lasted for 6 weeks, with PNE sessions conducted twice per week and physical exercise sessions three times per week. Outcome measures included the Pain Visual Analogue Scale (PVAS) for pain intensity, the Fear-Avoidance Beliefs Questionnaire (FABQ), the Roland-Morris Disability Questionnaire (RMDS) for functional disability, and the Back Pain Functional Scale (BPFS) for assessing back function. Data were analyzed using IBM SPSS software version 25.
Results: The intervention group showed significant improvements compared to the control group. PVAS scores decreased from an initial mean of 5.88 to 2.38 in the intervention group, indicating a reduction in pain intensity. FABQ scores in the intervention group decreased significantly, suggesting a reduction in fear-avoidance beliefs. RMDS and BPFS scores also showed considerable improvements in the intervention group, indicating enhanced functional ability and back function. The control group exhibited lesser improvements in these outcomes.
Conclusion: Combining pain neuroscience education with physical exercise is more effective in reducing pain intensity, fear-avoidance beliefs, and improving functional ability and back function in patients with lumbar radiculopathy compared to physical exercise alone. This study underscores the importance of a multimodal treatment approach in managing lumbar radiculopathy.
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