Low Back Pain and Comorbid Posttraumatic Stress Disorder

University of Southern Denmark (SDU)

Status: Unknown

Conditions: Posttraumatic Stress Disorder; Low Back Pain

Treatments: Behavioral: Physiotherapy; Behavioral: Psychotherapy

Study type: Interventional

Funder types: Other

Identifiers

NCT03244046

RCT2016PTSD

Details and patient eligibility

About

The aim is to test whether the psychotherapeutic intervention Somatic Experiencing targeting Post Traumatic Stress Disorder (PTSD) symptoms will have an additional positive effect on the outcomes of guided physiotherapy against chronic back pain development.

Full description

Introduction: Patients with low back pain after injuries often demonstrate symptoms of PTSD measured via the Harvard Trauma Questionnaire Scale (HTQ). It has been found that PTSD and pain may maintain each other.

Methods: Thousand consecutive patients with Low Back Pain (LBP) referred to the Spine Center are screened for PTSD. It is expected that 140 patients will meet the inclusion criteria and be randomized to Guided Physiotherapy or to Guided Physiotherapy plus 12 psychotherapeutic sessions, that will include the shock-trauma method 'Somatic Experiencing'.

Effect parameters are: Pain, daily function, EuroQOL and (HTQ), anxiety and depression, fear avoidance (Tampa Scale for Kinesiophobia) and pain catastrophizing (PCS) on entry, and at 6/12 months.

Enrollment: 140 estimated patients

Sex: All

Ages: 18 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Back pain: from 1/2 Y duration or longer
• Trauma according to HTQ

Exclusion criteria

• Planned surgery, comorbid psychiatry (except PTSD and mild to moderate depression), personality disorders, drug or medical abuse

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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140 participants in 2 patient groups

Physiotherapy (Phys)

Active Comparator group

Description:

12 sessions of guided physiotherapy for low back pain. Cognitive Behavioral Therapeutic elements included targeting Fear Avoidance Beliefs.

Treatment:

Behavioral: Physiotherapy

Somatic Experiencing + phys

Experimental group

Description:

12 sessions of psychotherapy (somatic experiencing) and 12 sessions of guided physiotherapy for low back pain. Cognitive Behavioral Therapeutic elements included targeting Fear Avoidance Beliefs.

Treatment:

Behavioral: Psychotherapy

Behavioral: Physiotherapy