Culture-sensitive and standard pain neuroscience education improves pain, disability, and pain cognitions in first-generation Turkish migrants with chronic low back pain: a pilot randomized controlled trial

ABSTRACT

Purpose: To compare the effectiveness of culture-sensitive and standard pain neuroscience education (PNE) on pain knowledge, pain intensity, disability, and pain cognitions in first-generation Turkish migrants with chronic low back pain (CLBP).

Methods: Twenty-nine Turkish first-generation migrants with CLBP were randomly assigned to the culture-sensitive (n = 15) or standard PNE (n = 14) groups. Primary (pain knowledge, pain intensity, and disability) and secondary outcomes (pain beliefs, catastrophization, and fear of movement) were evaluated at baseline, immediately after the second session of PNE (week 1), and after 4 weeks.

Results: There was a significant main effect of time in pain knowledge (p < .001), pain intensity (p = .03), disability (p = .002), organic and psychological pain beliefs (p = .002, p = .01), catastrophization (p = .002), and fear of movement (p = .02). However, no significant difference was found between groups in terms of all outcome measures (p > .05).

Conclusions: Both PNE programs resulted in improvements in knowledge of pain, pain intensity, perceived disability, and pain cognitions. Nevertheless, the superiority of the culture-sensitive PNE approach could not be proved. Therefore, maybe migrants who are living in the host country for longer length of time do not need culturally adapted therapies due to cultural integration, while these adaptations might be essential for the recent migrants or the autochthonous population in Turkey. Further research is required to investigate the effects of culture-sensitive PNE alone or in combination with physiotherapy interventions in recent migrants or Turkish natives with CLBP.

KEYWORDS:

• Low back pain
• education
• neurophysiology
• migrants
• culture

Acknowledgments

We would like to thank Auke De Bruyn, Aurelie Wandels, and Eline Carton for the data input. The first author (CO) would like to express her gratitude to the Scientific Research Department of Hacettepe University (Project number: TBI-2017-13866) for financially supporting her during the study period at Ghent University.

Disclosure statement

Authors declared no conflict of interest.

Additional information

Funding

This work was supported by the Hacettepe Üniversitesi [TBI-2017-13866].