The Effect of Pain Neuroscience Education with Motor Control and Core Stability Exercises on Non-Specific Chronic Low Back Pain in Women

Background: Non-specific chronic low back pain (CLBP) is a prevalent health issue, particularly among women. This study examined the effects of pain neuroscience education (PNE) combined with motor control exercise (MCE) and core stability exercises (CSE) on pain, function, and quality of life of women with non-specific CLBP.Methods: The present study used a pre-post intervention design with three parallel comparison groups. From the target population, 45 women with non-specific CLBP were selected using convenience sampling technique. Then, they were randomly assigned to three groups of 15 including PNE with MCE, CSE, and control group. In the pre-test phase, pain intensity was measured with the Visual Analog Scale (VAS), muscle function was measured using the McGill tests, and women’s quality of life was measured using the SF-36 Quality of Life questionnaire. The study was conducted in Urmia, Iran, in 2024. Subsequently, the experimental groups performed the exercises for eight weeks. Then, in the post-test phase, the factors measured in the pre-test phase were remeasured. Also, to analyze the data, paired sample t-tests and analysis of covariance (ANCOVA) were used to examine within and between group effects, respectively.Results: Both the PNE+MCE and CSE groups showed significant reductions in pain (Mean Difference (MD=) -2.93, P=0.001; MD=-1.08, P=0.005) and disability (MD=-7.25, P=0.001; MD=-3.93, P=0.001), along with improvements in trunk flexor endurance (MD=+11.31, P=0.001; MD=+5.44, P=0.001), trunk extensor endurance (MD=+14.68, P=0.001 MD=+4.41, P=0.001), quality of life (MD=+20.43, P=0.001; MD=+9.99, P=0.001), side plank (MD=10.41, P=0.001; MD=4.86, P=0.001), and elbow plank (MD=8.75, P=0.001 MD=5.13, P=0.001). Significant between-group differences were observed for all outcomes, with the PNE+MCE group demonstrating superior improvements over both CSE and control groups in pain (2.93 vs 1.08 vs -0.31), disability (7.25 vs 3.93 vs -0.40), trunk endurance (flexors: 11.31 vs 5.44 vs -1.27; extensors: 14.68 vs 4.41 vs -0.12), quality of life (20.43 vs 9.99 vs -3.23), side plank (10.41 vs 4.86 vs -0.85) and elbow plank (8.75 vs 5.13 vs -0.11), respectively.Conclusions: This study showed that PNE along with MCE plays an important role in managing pain and functional disability in women with non-specific CLBP. In addition, these findings suggested that this combined approach can help improve muscle function and quality of life for patients.