Effectiveness of pain neuroscience education on somatosensory functioning after surgery for breast cancer: A double‐blinded randomized controlled trial

Abstract

Pain is one of the most prevalent and long‐term adverse effects described by people who have undergone breast cancer surgery. Non‐helpful perceptions and thoughts about pain may contribute to the transition of acute to persistent pain. Adding educational interventions to the current physical therapy program in this population may help to improve or prevent persistent pain. Pain neuroscience education (PNE) is a type of educational intervention that addresses the experience of pain in a broader sense by explaining pain not only from a biomedical perspective, but also from a psychological and social perspective. A double‐blinded randomized controlled trial (EduCan trial) investigated whether PNE, in addition to a standard physiotherapy program immediately after surgery for breast cancer, was more effective on somatosensory functioning in the short (4 months postoperatively) and long term (18 months postoperatively), than providing a biomedical explanation for pain. Somatosensory functioning was evaluated using a self‐reported questionnaire as well as a comprehensive quantitative sensory testing evaluation. The findings of this study revealed that adding six sessions of PNE to a standard physical therapy program (n = 184) did not result in a significantly different course of somatosensory functioning up to 18 months postoperatively as compared to biomedical pain education. These findings provide an interesting basis for future research into who should receive PNE after surgery for breast cancer (e.g., patient profiling or phenotyping) and how we can tailor it to the individual to increase its effectiveness.

NEUROCANTRIAL: study protocol for a randomised controlled trial of a pain neuroscience education programme in adults with cancer pain

“…Furthermore, a study carried out by De Groef et al 22 aimed to investigate the effectiveness of PNE intervention for the treatment and prevention of pain and for improvement in physical, emotional and work-related functioning after breast cancer surgery, compared with BME. The results of this protocol were recently published by Dams et al 23 finding that patients who received PNE after 6 months of breast cancer surgery showed a decreased sensitivity to pressure pain in the trunk, compared with the BME group. However, no significant differences were found between the types of education received.…”

Pain after cancer: Time to move towards a mechanism‐based approach!

“…Finally, the paper of Dams et al (2024) explores the possibilities of prevention of chronic pain after breast cancer by targeting top‐down sensitization modulated by pathways linked to brain regions associated with psychological factors and pain cognitions by means of Pain Neuroscience Education. These interventions aim to tackle maladaptive pain cognitions (e.g., pain‐related worrying) or psychosocial functioning (e.g., anxiety and depression), as they can facilitate the transmission of nociceptive stimuli to the brain and may contribute to cognitive‐emotional sensitization of the somatosensory nervous system.…”

Effectiveness of Pain Neuroscience Education on Chronic Pain in Diabetic Neuropathy

“…The rationale for this research lies in the chronic nature of diabetic neuropathic pain and the need for effective management strategies. Pain Neuroscience Education, an evidence-based approach for managing chronic pain across various conditions, is chosen as the focus of this study (2, 13,14). The primary objective is to evaluate the impact of Pain Neuroscience Education on chronic pain in patients with diabetic neuropathy (15).…”