Pain Neuroscience Education in Physiotherapy Students With Chronic Non-Specific Low Back Pain

Immediate Effects of Pain Neuroscience Education in Physiotherapy Students With Chronic Non-specific Low Back Pain: a Pre-Post Intervention Study

This study aims to examine the immediate effects of a single-session Pain Neuroscience Education (PNE) program in physiotherapy students who experience chronic non-specific low back pain. The PNE session focuses on explaining pain mechanisms, central sensitization, and the role of psychological, cognitive, and behavioral factors in chronic pain. Participants complete outcome measures assessing pain intensity, pain knowledge, pain catastrophizing, and kinesiophobia before and immediately after the intervention. The purpose of the study is to determine whether a brief educational session can produce immediate improvements in pain-related outcomes in a student population.

Study Overview

• Status: Completed
• Conditions: Chronic Non-specific Low Back Pain; Physiotherapist Students
• Intervention / Treatment: Behavioral: Pain Neuroscience Education (PNE)

Detailed Description

This study is a retrospective registration of a completed pre-post interventional study conducted among undergraduate physiotherapy students with chronic non-specific low back pain. The objective of the research was to evaluate the immediate effects of a single-session Pain Neuroscience Education (PNE) program on pain intensity, pain knowledge, pain-related beliefs, pain catastrophizing, and kinesiophobia.

The PNE session lasted approximately 70 minutes and was delivered by a physiotherapist trained in pain neuroscience and the biopsychosocial model. The session covered pain neurophysiology, the distinction between acute and chronic pain, central sensitization, factors contributing to persistent pain, and the role of cognition, emotions, and behaviors in pain experiences.

Participants completed self-report outcome measures at two time points:

Baseline (pre-intervention)

Immediately after the intervention

Outcome measures included the Numeric Pain Rating Scale (NPRS), Revised Neurophysiology of Pain Questionnaire (RNPQ), Pain Catastrophizing Scale (PCS), and Tampa Scale for Kinesiophobia (TSK). The study followed a single-group design with no control group and no randomization.

The study was conducted between April and October 2025 at Karabük University, Turkey. Ethical approval was obtained from the Karabük University Non-Interventional Clinical Research Ethics Committee (Decision No: 2025/2208), and written informed consent was obtained from all participants prior to data collection.

The results of this research aim to contribute to the understanding of how pain neuroscience education may provide immediate benefits in young adults experiencing chronic non-specific low back pain, particularly within a physiotherapy student population. The findings may support the integration of pain education approaches in physiotherapy curricula and early clinical training programs.

• Study Type: Interventional
• Enrollment (Actual): 79
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Karabük, Turkey (Türkiye), 78050
    • Karabük University Faculty of Health Sciences

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Undergraduate physiotherapy and rehabilitation students
• Chronic non-specific low back pain for at least 3 months
• Pain intensity ≥3/10 on the Numeric Pain Rating Scale in the last week
• willing to participate

Exclusion Criteria:

• History of back surgery within the last 6 months
• Presence of neurological, orthopedic, cardiac, or systemic chronic disease
• Current participation in any physiotherapy, exercise, or medical treatment for low back pain

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Pain Neuroscience Education Group; Single-group intervention arm receiving a 70-minute Pain Neuroscience Education session. Outcome measures were collected at baseline and immediately after the intervention.	Behavioral: Pain Neuroscience Education (PNE); The program consists of a single 70-minute Pain Neuroscience Education (PNE) session, which includes explanations of pain neurophysiology, central sensitization, biopsychosocial pain concepts, and cognitive-behavioral factors influencing chronic pain. Delivered by a trained certified physiotherapist.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain Intensity (Numeric Pain Rating Scale)	Pain intensity was measured using the Numeric Pain Rating Scale (NPRS), a 0-10 scale where higher scores indicate greater pain. Participants report their average low back pain in the last week. In the NPRS, individuals were asked to verbally rate the severity of their pain on a scale from 0 to 10. The minimum clinically significant difference for the NPRS was reported as 2 points.	Baseline and immediately after the intervention
Pain Knowledge (Revised Neurophysiology of Pain Questionnaire - rNPQ)	Pain knowledge was measured using the Revised Neurophysiology of Pain Questionnaire (rNPQ). Higher scores indicate deeper understanding of pain neurophysiology.	Baseline and immediately after the intervention
Pain Catastrophizing (Pain Catastrophizing Scale - PCS)	Pain catastrophizing was measured using the Pain Catastrophizing Scale (PCS). The Likert-type scale consists of 13 items, with each item scored from 0 (strongly disagree) to 4 (strongly agree). The higher the total score, the higher the degree of negative and exaggerated thoughts about pain	Baseline and immediately after the intervention
Kinesiophobia (Tampa Scale of Kinesiophobia - TSK)	Kinesiophobia was assessed using the Tampa Scale for Kinesiophobia (TSK). Higher scores reflect greater fear of movement and reinjury. The TSK has a total of 17 items, and each item is scored using a 5-point Likert scale ranging from 1 = "disagree" to 4 = "strongly agree." The total score ranges from 17 to 68, with higher scores indicating greater fear of injury.	Baseline and immediately after the intervention

Collaborators and Investigators

• Sponsor: Ayşe ŞİMŞEK
• Investigators: Study Director: Ayşe Şimşek, MSc, Karabuk University

Study record dates

Study Major Dates

• Study Start (Actual): April 1, 2025
• Primary Completion (Actual): October 31, 2025
• Study Completion (Actual): October 31, 2025

Study Registration Dates

• First Submitted: November 18, 2025
• First Submitted That Met QC Criteria: November 18, 2025
• First Posted (Actual): November 25, 2025

Study Record Updates

• Last Update Posted (Actual): November 25, 2025
• Last Update Submitted That Met QC Criteria: November 18, 2025
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Keywords: low back pain; physiotherapy; pain neuroscience education; pain knowledge
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Back Pain; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Low Back Pain
• Other Study ID Numbers: KBU-2025-2208

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No