Pain neuroscience education for adults with chronic musculoskeletal pain: a mixed-methods systematic review and meta-analysis

James Watson, Cormac Ryan, Lesley Cooper, Dominic Ellington, Robbie Whittle, Michael Lavender, John Dixon, Greg Atkinson, Kay Cooper, Denis Martin

Research output: Contribution to journalReview article

Abstract

Chronic musculoskeletal pain (CMP) is an urgent global public health concern. Pain neuroscience education (PNE) is an intervention used in the management of CMP aiming to reconceptualise an individual’s understanding of their pain as less threatening. This mixed-methods review undertook a segregated synthesis of quantitative and qualitative studies to investigate the clinical effectiveness, and patients’ experience of, PNE for people with CMP. Electronic databases were searched for studies published between 01/01/2002 and 14/06/2018. Twelve randomised controlled trials (n = 755) that reported pain, disability and psychosocial outcomes and four qualitative studies (n = 50) that explored patients experience of PNE were included. The meta-analysed pooled treatment effects for PNE vs control had low clinical relevance in the short-term for pain (-3.20/100; 95%CI -6.66 to 0.27) and disability (-4.10/100; 95%CI -7.89 to -0.32) and the medium-term for pain (-4.22/100; 95%CI -16.44 to 8.01) and disability (-8.23/100; 95%CI -15.61 to -0.84). The treatment effect of PNE for kinesiophobia was clinically relevant in the short-term (-13.55/100; 95%CI -25.89 to -1.21) and for pain catastrophising in the medium-term (-5.26; 95%CI -10.59 to 0.08). Meta-synthesis of 23 qualitative findings resulted in the identification of two synthesized findings that identified several key components important for enhancing the patient experience of PNE such as allowing the patient to tell their own story. These components can enhance pain reconceptualisation, which appears to be an important process to facilitate patients’ ability to cope with their condition. The protocol was published on PROSPERO (CRD42017068436).
Original languageEnglish
Number of pages80
JournalJournal of Pain
Early online date1 Mar 2019
DOIs
Publication statusPublished - 1 Mar 2019

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Musculoskeletal Pain
Neurosciences
Chronic Pain
Meta-Analysis
Education
Pain
Aptitude
Randomized Controlled Trials
Public Health

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title = "Pain neuroscience education for adults with chronic musculoskeletal pain:: a mixed-methods systematic review and meta-analysis",
abstract = "Chronic musculoskeletal pain (CMP) is an urgent global public health concern. Pain neuroscience education (PNE) is an intervention used in the management of CMP aiming to reconceptualise an individual’s understanding of their pain as less threatening. This mixed-methods review undertook a segregated synthesis of quantitative and qualitative studies to investigate the clinical effectiveness, and patients’ experience of, PNE for people with CMP. Electronic databases were searched for studies published between 01/01/2002 and 14/06/2018. Twelve randomised controlled trials (n = 755) that reported pain, disability and psychosocial outcomes and four qualitative studies (n = 50) that explored patients experience of PNE were included. The meta-analysed pooled treatment effects for PNE vs control had low clinical relevance in the short-term for pain (-3.20/100; 95{\%}CI -6.66 to 0.27) and disability (-4.10/100; 95{\%}CI -7.89 to -0.32) and the medium-term for pain (-4.22/100; 95{\%}CI -16.44 to 8.01) and disability (-8.23/100; 95{\%}CI -15.61 to -0.84). The treatment effect of PNE for kinesiophobia was clinically relevant in the short-term (-13.55/100; 95{\%}CI -25.89 to -1.21) and for pain catastrophising in the medium-term (-5.26; 95{\%}CI -10.59 to 0.08). Meta-synthesis of 23 qualitative findings resulted in the identification of two synthesized findings that identified several key components important for enhancing the patient experience of PNE such as allowing the patient to tell their own story. These components can enhance pain reconceptualisation, which appears to be an important process to facilitate patients’ ability to cope with their condition. The protocol was published on PROSPERO (CRD42017068436).",
author = "James Watson and Cormac Ryan and Lesley Cooper and Dominic Ellington and Robbie Whittle and Michael Lavender and John Dixon and Greg Atkinson and Kay Cooper and Denis Martin",
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Pain neuroscience education for adults with chronic musculoskeletal pain: a mixed-methods systematic review and meta-analysis. / Watson, James; Ryan, Cormac; Cooper, Lesley; Ellington, Dominic ; Whittle, Robbie ; Lavender, Michael ; Dixon, John; Atkinson, Greg; Cooper, Kay; Martin, Denis.

In: Journal of Pain, 01.03.2019.

Research output: Contribution to journalReview article

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T1 - Pain neuroscience education for adults with chronic musculoskeletal pain:

T2 - a mixed-methods systematic review and meta-analysis

AU - Watson, James

AU - Ryan, Cormac

AU - Cooper, Lesley

AU - Ellington, Dominic

AU - Whittle, Robbie

AU - Lavender, Michael

AU - Dixon, John

AU - Atkinson, Greg

AU - Cooper, Kay

AU - Martin, Denis

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