Effects of education to facilitate knowledge about chronic pain for adults: a systematic review with meta-analysis

Abstract

BackgroundChronic pain can contribute to disability, depression, anxiety, sleep disturbances, poor quality of life and increased health care costs, with close to 20 % of the adult population in Europe reporting chronic pain. To empower the person to self-manage, it is advocated that education and training about the nature of pain and its effects and how to live with pain is provided. The objective of this review is to determine the level of evidence for education to facilitate knowledge about chronic pain, delivered as a stand-alone intervention for adults, to reduce pain and disability.MethodsWe identified randomised controlled trials of educational intervention for chronic pain by searching CENTRAL, MEDLINE, EMBASE and ongoing trials registries (inception to December 2013). Main inclusion criteria were (1) pain >3 months; (2) study design that allowed isolation of effects of education and (3) measures of pain or disability. Two reviewers independently screened and appraised each study.ResultsNine studies were analysed. Pooled data from five studies, where the comparator group was usual care, showed no improvement in pain or disability. In the other four studies, comparing different types of education, there was no evidence for an improvement in pain; although, there was evidence (from one study) of a decrease in disability with a particular form of education—pain neurophysiology education (PNE). Post-hoc analysis of psychosocial outcomes reported in the studies showed evidence of a reduction in catastrophising and an increase of knowledge about pain following PNE.ConclusionsThe evidence base is limited by the small numbers of studies, their relatively small sample sizes, and the diversity in types of education studied. From that limited evidence, the only support for this type of education is for PNE, though it is insufficiently strong to recommend conclusively that PNE should be delivered as a stand-alone intervention.It therefore remains sensible to recommend that education be delivered in conjunction with other pain management approaches as we cannot confidently conclude that education alone is effective in reducing pain intensity or related disability in chronic pain in adults.Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-015-0120-5) contains supplementary material, which is available to authorized users.

Pain Self-Management: Easier Said than Done? Factors Associated with Early Dropout from Pain Self-Management in a Rural Primary Care Population

“…Of note, the question about belief was asked after all participants had been provided with a biopsychosocial explanation of their pain in the introductory session. Given that only 29% of people reported a multifactorial understanding of pain cause, this one-off education session appeared insufficient to change beliefs, as suggested by other studies (56). Research on belief formation about pain cause has noted that healthcare providers, especially general practitioners (GPs) are a trusted source for such information and are likely to strongly influence patient beliefs (57,58).…”

Pain Neuroscience Education and Physical Therapeutic Exercise for Patients with Chronic Spinal Pain in Spanish Physiotherapy Primary Care: A Pragmatic Randomized Controlled Trial

“…Some research has shown that intense PNE interventions are more effective [51]. However, the effectiveness of PNE as an isolated treatment technique is limited [47] and its effects increase when combined with a targeted PE program [52,53]. PE is a first-choice treatment in the management of CMP [9][10][11][12][13][14], and PE in particular has proven to be a useful tool in the treatment of CMP.…”

An exploration of the extent and nature of reconceptualisation of pain following pain neurophysiology education: A qualitative study of experiences of people with chronic musculoskeletal pain

“…Emerging evidence suggests that PNE can be effective for pain and function -physical, psychological and social [3,4,5,6,7,8,9]. While most studies have focused on changes in these outcomes, less attention has been paid to exploring the mechanisms by which PNE works.…”