Low Back Pain
Conditions
Brief summary
The purpose of this study is to evaluate patients with low back pain who are scheduled to begin physical therapy but have not yet had their first appointment to better understand their beliefs and attitudes and to evaluate the effects of an educational session about low back pain.
Detailed description
The investigators will conduct a randomized trial to examine the effectiveness of a patient education session provided prior to beginning physical therapy on outcomes of usual physical therapy for acute/sub-acute low back pain patients. The study compares two groups, one group will be treated with usual physical therapy with no pre-treatment education and the other group will also receive the pre-treatment. Patients will be followed after 6 weeks and 3 months. Physical therapy care is left to the discretion of the physical therapist in conjunction with the patient. Outcomes will include pain and disability, and patients attitude and believes (pain catastrophizing, fear avoidance behavior). The overall hypothesis is that the additional educational treatment may address and improve pain, disability and fear.
Interventions
BEHAVIORALPatient Education
An educational video was watched based on Consumer Reports Choosing Wisely patient education supporting the recommendation that imaging is not helpful early for low back pain and the best strategy is to remain as active as possible. Key themes were discussed with a physical therapist and the patient's questions were answered.
OTHERControl
Patients receive no additional intervention. They will begin physical therapy and receive care at the therapist's discretion.
Sponsors
University of Utah
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Chief complaint of non-specific low back pain scheduled to receive outpatient physical therapy * age 18-60 * duration of current symptoms \< 8weeks * referred to physical therapy from a non-surgeon provider * no treatment received for low back pain in past year other than physician office visits.
Exclusion criteria
* Diagnosis provided by the referral source indicating a specific pathoanatomical source for LBP including fracture, spondylolesthesis, ankylosing spondylitis, radiculopathy * any red flags in the patient's general medical screening questionnaire (i.e. tumor, metabolic diseases etc.).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Oswestry Disability Index | 6 weeks | Self-report measure of low back pain-related disability |
| Pain as measured by the Numeric Pain Rating Scale | 6 weeks | Self-report measure of pain intensity on 0-10 rating scale |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pain Catastrophizing Scale | baseline, 6 weeks, 3 months | Self-report measure of pain catastrophizing beliefs |
| Pain Beliefs Questionnaire | baseline, 6 weeks, 3 months | Self-report questionnaire used to measure patients' beliefs about the causes and consequences of pain with 2 subscales: organic (i.e, biomedical) and psychological. |
| Physical Therapy Visits: Number of physical therapy episodes attended after baseline | 6 weeks, 3 months | Number of physical therapy episodes attended after baseline |
| Global Rating of Change | 6 weeks, 3 months | Self-report global rating of improvement in condition since baseline assessed on 0-15 scale |
| Hospital Anxiety and Depression Scale | baseline, 6 weeks, 3 months | Self-report questionnaire assessing anxiety and depression in separate sub-scales |
| Oswestry Disability Scale | baseline, 3 months | Self-report measure of low back pain-related disability |
| Numeric Pain Rating | baseline, 3 months | Self-report measure of pain intensity on 0-10 scale |
| Treatment Self-Regulation Questionnaire | baseline, 6 weeks, 3 months | Self-report questionnaire examining motivations to attend physical therapy |
| Fear Avoidance beliefs Questionnaire | baseline, 6 weeks, 3 months | Self-report measure of fear avoidance beliefs about physical activity and work |
Countries
United States
Outcome results
None listed