Reconsolidation Blockade with Propranolol as a Novel Treatment for Chronic Low-Back Pain: A Double-Blind Randomized Placebo-Controlled Feasibility Study

Alexia Coulombe-Leveque; Sylvie Lafrenaye; Alain Brunet; Serge Marchand; Guillaume Leonard

doi:10.2147/JPR.S566843

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Reconsolidation Blockade with Propranolol as a Novel Treatment for Chronic Low-Back Pain: A Double-Blind Randomized Placebo-Controlled Feasibility Study

Alexia Coulombe-Leveque, Sylvie Lafrenaye, Alain Brunet, Serge Marchand and Guillaume Leonard

Journal of Pain Research, Vol.19, pp.1-15

2026

DOI: https://doi.org/10.2147/JPR.S566843

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Abstract

reconsolidation therapy

nociplastic pain

post-traumatic stress disorder

amygdala

Purpose: Nociplastic pain is often characterized by maladaptive plasticity in the nervous system similar to that observed in patients with post-traumatic stress disorder (PTSD). The aim of this study was to investigate whether reconsolidation therapy, a treatment for PTSD consisting in reactivating (through trauma narrative) the synapses encoding the excessive threat response and blocking their reconsolidation using propranolol, is feasible in patients with nociplastic low-back pain. Patients and Methods: Design: triple-blind, placebo-controlled feasibility study. Population: 24 adults with chronic (> 6 months) nociplastic low-back pain with no comorbid PTSD or contra-indication to propranolol. Intervention: Pain education (10 short videos) and 6 weekly sessions of reconsolidation therapy with propranolol (n=12) or placebo (n=12) administered orally 1h pre-reactivation. Outcome measures: Feasibility: recruitment rates, adverse events (frequency/severity). Effect of intervention: Brief Pain Inventory (BPI) and other self-reported pain questionnaires, 4 weeks post-intervention. Results: Sixty-six patients were screened over 6 months; 24 participants were enrolled; 2 dropped out. Adverse events were mild and infrequent (asymptomatic decrease in heart rate (n=4), headache and nausea (n=1)). No clinically meaningful difference was observed between the two groups on the pain questionnaires at the 4-week follow-up. Prevalent catastrophic/kinesiophobic discourse was noted during the sessions, and the reactivation methods appeared to have been suboptimal for the population. Conclusion: Reconsolidation therapy is a feasible intervention for chronic pain. Preliminary results suggest no effect on pain symptoms. Additional studies are warranted to assess the adequacy of reactivation procedures (proper reactivation being required to trigger reconsolidation), and to investigate whether the absence of negative pain beliefs might be a prerequisite (unmet in this study) for the success of the intervention.

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Title: Reconsolidation Blockade with Propranolol as a Novel Treatment for Chronic Low-Back Pain: A Double-Blind Randomized Placebo-Controlled Feasibility Study
Authors: Alexia Coulombe-Leveque - Université de Sherbrooke
Sylvie Lafrenaye - Université de Sherbrooke
Alain Brunet - University of the Sunshine Coast, Queensland, Thompson Institute
Serge Marchand - Université de Sherbrooke
Guillaume Leonard (Corresponding Author) - Université de Sherbrooke
Publication details: Journal of Pain Research, Vol.19, pp.1-15
Publisher: Dove Medical Press Ltd.
Date published: 2026
DOI: 10.2147/JPR.S566843
ISSN: 1178-7090
Copyright note: © 2026 The Author(s). This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, 4.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
Data Availability: The data used in the present study are available from the corresponding author upon request.
Grant note: The first author is supported by a Fellowship from the Canadian Institutes of Health Research Fellowship. The study was funded by a Pilot Study award from the Quebec Pain Research Network (Fonds de recherche du Québec – Santé). GL received salary support from the Fonds de recherche du Québec – Santé (Senior Clinical Research Scholar).
Organisation Unit: Thompson Institute
Language: English
Record Identifier: 991210067402621
Output Type: Journal article

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