Nature-based Intervention for Chronic Pain

(PARC-2 Trial)

Overseen By Émilie Fortin, M.Sc

Age: 65+

Sex: Any

Trial Phase: Academic

Sponsor: Université du Québec à Chicoutimi

Disqualifiers: Severe musculoskeletal, cardiovascular, neurological, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 8

15 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether spending time in nature can improve physical and mental health for older adults with chronic lower back pain. Participants will join weekly nature-based sessions to determine if this approach enhances mobility, strength, and overall well-being. It suits individuals aged 65 and over who have experienced lower back pain for more than three months and can walk unaided. As an unphased trial, it provides a unique opportunity to explore innovative, natural methods to enhance well-being.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What prior data suggests that this nature-based intervention is safe for older adults with chronic pain?

Research has shown that nature-based treatments are generally safe and easy to manage. Studies have found that these treatments can improve overall well-being in people with long-term pain, offering a promising alternative to traditional methods. Although specific side effects are not highlighted, evidence suggests that nature-based approaches benefit both physical and mental health without causing major side effects.

Evidence from studies indicates that nature-based activities have helped people with fibromyalgia, a condition associated with long-term pain, without significant safety issues. This supports the likelihood that such treatments are safe for broader use in managing chronic pain.

Since this trial tests a non-drug treatment, safety concerns are much lower compared to those with medications, providing reassurance about its safety for participants. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Unlike standard treatments for chronic pain, which often rely on medications like opioids or physical therapy, the nature-based intervention offers a completely different approach by utilizing the healing potential of natural environments. This treatment involves spending two hours a week in nature for eight weeks, tapping into the therapeutic benefits of being outdoors, which can include reduced stress and improved mood. Researchers are excited about this because it could offer a non-invasive, drug-free alternative that promotes overall well-being and potentially alleviates pain through direct interaction with natural surroundings.

What evidence suggests that this nature-based intervention is effective for chronic pain?

Research has shown that spending time in nature can alleviate chronic pain and enhance overall health. Studies have found that outdoor activities may reduce pain and improve the quality of life for those with chronic pain. Additionally, natural settings can encourage more physical activity, increase strength, and improve balance. Other research suggests that nature might act as a natural painkiller by altering the brain's response to pain. These positive effects indicate that nature-based activities, such as the intervention being tested in this trial, could help manage chronic lower back pain. ^{1 4 6 7 8}

Who Is on the Research Team?

Rubens A. da Silva, Ph.D.

Principal Investigator

Université du Québec à Chicoutimi

Marie-Ève Langelier, MD

Principal Investigator

Université du Québec à Chicoutimi

Émilie Fortin, M.Sc

Principal Investigator

Université du Québec à Chicoutimi

Guillaume Léonard, Ph.D.

Principal Investigator

Université de Sherbrooke

Are You a Good Fit for This Trial?

This trial is for people aged 65 or older who have had lower back pain for at least three months, can walk on their own, are mentally sharp (scoring over 25/30 on a mental state exam), and aren't very frail. It's not for those with severe muscle, heart, nerve problems or serious diseases like cancer.

Inclusion Criteria

I have had low back pain for at least 3 months.

I can walk on my own without help.

Mental state >25/30 in the MMSE questionnaire

Exclusion Criteria

I do not have severe musculoskeletal, cardiovascular, neurological conditions, or other systemic diseases.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Nature-based Intervention

Participants engage in an 8-week nature-based intervention program, including activities such as walking, meditation, gardening, and pain education, conducted once a week for 2 hours.

8 weeks

8 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after the intervention, with assessments of physical and psychosocial health outcomes.

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Nature-based Intervention

Trial Overview The study tests if a nature-based program helps older adults with chronic back pain improve mobility, strength, balance and psychosocial health. Participants will be checked before and after the program and attend weekly sessions.

How Is the Trial Designed?

Group I: Nature-based intervention Experimental Treatment 1 Intervention

Nature-based intervention group of once a week (2 hours) for 8 weeks

Who Is Running the Clinical Trial?

Université du Québec à Chicoutimi

Lead Sponsor

Trials

7

Recruited

320+

FUQAC

Collaborator

Fonds de la Recherche en Santé du Québec

Collaborator

Trials

84

Recruited

46,700+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10538778/

The effect of nature exposure on pain experience and ... This proposed systematic review aims to examine the effects of nature exposure therapy on pain experience and quality of life in patients with chronic pain.

2. clinicaltrials.gov clinicaltrials.gov/study/NCT07002853

Nature-based Intervention for Chronic Pain in Older People Data collection will include both quantitative and qualitative measures. Quantitative outcomes will assess pain disability, quality of life, kinesiophobia (fear ...

3. sciencedirect.com sciencedirect.com/science/article/pii/S0013935124013264

Nature-based interventions for physical health conditions This review found some beneficial effects in favour of NBIs for health outcomes in at least three condition groups though RoB and inconsistent effects limited ...

4. mdpi.com mdpi.com/2673-9259/5/3/35

The Impact of Nature-Based Interventions on Physical ... The main significant improvements compared with the control groups were found in: physical measures: Time of moderate physical activity, upper body strength and ...

5. nature.com nature.com/articles/s41467-025-56870-2

Nature exposure induces analgesic effects by acting on ... This preregistered neuroimaging study investigates how nature modulates nociception-related and domain-general brain responses to acute pain.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11671320/

Harnessing the therapeutic effects of nature for chronic Pain This review article summarizes key multidisciplinary evidence to help understand how nature exerts beneficial effects on pain processing.

7. nature.com nature.com/articles/s41746-025-01553-x

Telehealth virtual reality intervention reduces chronic pain ... In a 5-week crossover trial, we compared VR to matched audio content control in individuals with chronic pain. VR significantly reduced pain intensity, anxiety ...

8. sciencedirect.com sciencedirect.com/science/article/pii/S1524904223001285

Effects of Nature-Based Multisensory Stimulation on Pain ... Women with fibromyalgia syndrome may benefit from multisensory stimulation using biotic and abiotic agents from natural environments for 30 minutes.