Pain Science Education and Graded Exposure for Chronic Low Back Pain

Chronic low back pain can affect daily activities and may be influenced by how people understand pain, their fear of movement, and their responses to stressful or uncertain physical activities. This clinical trial will evaluate whether a 6-week program combining pain science education with graded exposure to movement is more effective than usual physical therapy for adults with chronic low back pain. Participants will be randomly assigned to one of two groups: pain science education combined with graded exposure to movement, or usual physical therapy. The study will assess changes in pain, disability, fear of movement, and pain-related thoughts. It will also examine physiological responses to stress and muscle activity while participants perform a lifting task. The study aims to determine whether combining education about pain with gradual exposure to feared movements can improve clinical outcomes, physiological responses to stress, and motor performance in people with chronic low back pain.

Inclusion Criteria: * Men and women aged 18 to 60 years. * Diagnosis of chronic low back pain, defined as low back pain occurring every day for at least 3 months or on at least half of the days during the previous 6 -months. * Willingness to participate in the study. Exclusion Criteria: * Body mass index \>30 kg/m². * Inability to understand study instructions. * Neurological conditions affecting the central nervous system (e.g., stroke or spinal cord injury). * Pregnancy. * Currently receiving alternative therapies. * Previous participation in a pain education program. * History of trauma or orthopedic surgery within the previous 12 months.