The aim of this study was to investigate short and mid-term effects of manual therapy and neuroplastic pain education on pain severity, pressure pain threshold, two-point discrimination, back performance, functional level and kinesiophobia in patients with chronic low back pain.

Sixty-nine patients with chronic low back pain were divided randomly into three groups. Following recording the demographics of all participants, Numeric Pain Rating Scale for measurement of pain severity, Baseline® algometer for measurement of pain pressure threshold, Baseline® estesiometer for measurement of two-point discrimination, Back Performance Scale for measurement back performance, Oswestry Disability Index for measurement functional level and Tampa Kinesiophobia Scale for measurement kinesiophobia were used. All measurements were performed at baseline, after treatment and end of three months by same blinded physiotherapist.

The first group received manual therapy for four weeks as two sessions per week, while the second group received four sessions of neuroplastic pain education in addition to manual therapy sessions. The last group was determined as the control group. Results: All of three groups had significant group, time and group*time effects on reducing pain severity, increasing pressure pain threshold, improving two-point discrimination, improving back performance, increasing functional level and reducing kinesiophobia (p<0,05). Besides, the effect of both treatment groups on all parameters was found to be superior to the control group. The effectiveness of the manual therapy and neuroplastic pain education program was retained at the three months’ follow-up, whereas it was not retained in the manual therapy group.

As a result of this study, the effect of manual therapy and neuroplastic pain education group was found to be superior to other groups. It is thought that the effects of manual therapy increase by the addition of cognitive treatment methods such as neuroplastic pain education in the treatment of patients with chronic low back pain. Future studies should investigate the long term effectiveness of manual therapy and neuroplastic pain education.

– Study made by Ismail Saracoglu

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