Combining Brain Stimulation and Physiotherapy for the Management of Chronic Low Back Pain

Chronic low back pain (CLBP) is a major health challenge in Canada, leading to substantial disability and socioeconomic burden, particularly among Veterans. In military Veterans, LBP is the most common chronic pain condition. Conventional interventions have limited effectiveness. The refractoriness to interventions suggests that specific CLBP mechanisms may be missed by current treatments, prompting a shift towards psychologically informed approaches which aim to address emotional and cognitive factors alongside biomedical aspects. The integration of these concepts into physiotherapy is called psychologically informed physiotherapy (PiP). Despite promising results of PiP from randomized controlled trials, residual pain and disability often persist in Veterans. Non-invasive brain stimulation, such as repetitive transcranial magnetic stimulation (rTMS), may enhance the effectiveness of PiP by modulating cognition, emotion, and pain. This proposal seeks to determine whether non-invasive brain stimulation can enhance the effects of PiP.

NCT Number	NCT06999772
Lead Sponsor	Laval University Collaborators: Chronic Pain Centre of Excellence for Canadian Veterans, Foundation for Physical Medicine and Rehabilitation
Conditions	Chronic Low-back Pain (cLBP)
Enrollment	96 participants
Start Date	2025-06-11
Primary Completion	2026-11-01 (estimated)
Study Completion	2027-06-01 (estimated)
Updated on ClinicalTrials.gov	2026-01-20