Changes in Pain Catastrophizing and Related Outcomes Following a Single-Session Empowered Relief Intervention Delivered by Physical Therapists in Workers with Low Back Pain: A Pilot Study.

Abstract

Purpose: Low back pain is among the most prevalent pain conditions. Cognitive behavioral therapy reduces the negative effects of low back pain, but access to treatment is limited. Empowered Relief is a 2-hour single-session pain management skills intervention that has demonstrated efficacy at improving pain outcomes in individuals with chronic low back pain. The objectives were 1) to assess the acceptability of Empowered Relief delivered by physical therapists in a sample of French-Canadian workers with low back pain; and 2) to explore changes in pain catastrophizing and other pain-related outcomes following Empowered Relief and physical therapy.

Methods: The study was an uncontrolled prospective pilot trial of Empowered Relief and physical therapy for low back pain. Participants were 63 French-Canadian individuals undergoing physical therapy for subacute and chronic low back pain (<1 year duration). Participants completed baseline measures of demographic and measure of pain catastrophizing, pain intensity, symptoms of anxiety and depression, physical function and pain interference before taking part in a single-session 2-hour Empowered Relief virtual course. Participants then completed a post-class acceptability questionnaire and a 4-week follow-up questionnaire assessing the same measures as baseline.

Results: A 2-hour single-session of Empowered Relief demonstrated high acceptability among participants. Pain catastrophizing scores reduced by an average of 28 points, with 90% achieving clinically significant change. Participation in Empowered Relief and physical therapy was associated with reductions in pain intensity, and clinically meaningful improvements in symptoms of anxiety and depression, physical function and pain interference at 4-weeks follow-up. Effect sizes were moderate to large, and the largest changes were found in individuals with subacute low back pain.

Conclusion: Empowered Relief, when delivered by physical therapists, may offer a rapid, scalable intervention to complement physical therapy and improve early outcomes in workers with low back pain. The results provide evidence to support a future randomized controlled trial evaluating the effect of Empowered Relief delivered by physical therapists for low back pain.