Effect of Cognitive Behavioral Therapy on Chronic Low Back Pain With Sensitization
Chronic Low Back Pain, Central Sensitisation
About this trial
This is an interventional treatment trial for Chronic Low Back Pain focused on measuring Cognitive Behavioural Therapy, Flexion Relaxation Phenomenon, Electromyography, Biofeedback, Functional Training
Eligibility Criteria
Inclusion Criteria:
- Age between 18- 50.
- Patient must have experienced low back pain for at least 3 months.
- Patient must have a score above or equal 40 in the Central Sensitization Inventory (CSI) (Neblett R. C., 2013) (Neblett R, 2015) (Neblett H. M., 2016) (R. De Pauw, 2015) (Mayer TG N. R., 2012) .
- Patient must have a score of 3 and above on the Numerical Pain Rating Scale.
Exclusion Criteria:
- Patients were excluded if they had taken pain medications on the day of the assessment.
- Patient who had serious spinal pathologies, such as fractures, tumors or inflammatory diseases, such as ankylosing spondylitis, narrowing of spinal canal and other conditions or severe cardiorespiratory diseases.
- Uncontrolled mental health condition that prevents successful compliance.
Sites / Locations
- MTI University
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Cognitive Behavioural Therapy
Strengthening and Core Stability
Following assessment a one on one session will be given comprising education cognitively targeting false ideas and beliefs on the nature of pain, differentiating nociception due to a painful stimulus and the transition of such a stimulus to a centrally sensitized experience due to misinformation, maladaptive behaviour and fear avoidance. Upon completion of the session assessment using the NPQ will be done to assess the understanding of the patient and further address any shortcomings in future exercise sessions. Another SEMG recording of the Flexion Relaxation phenomenon will be upon completion of the educational session and a SEMG biofeedback session will begin to help the patient regain their sense of control over their body and function. After the SEMG biofeedback session a graded exposure exercise program of strengthening and functional training starting from the least feared movements to the most over 10 sessions over 5 weeks.
Following assessment 12 sessions over 6 weeks will start, focusing on strengthening exercises of the transversus abdominis and lumbar multifidus muscles (Angela Searle, 2015). Exercises will be graduated according to the patient pain tolerance.