Pain neuroscience education intervention for patients who experience chronic musculoskeletal pain with concurrent opioid dependence: A pilot study

OBJECTIVE: The objectives were to examine changes in kinesiophobia, pain self-efficacy, and knowledge of the neurophysiology of pain. We hypothesized that implementing an adapted-pain neuroscience education (a-PNE) curriculum, as a single intervention, for patients who experience chronic musculoskeletal pain and concurrent opioid dependence, would demonstrate positive change in kinesiophobia and self-efficacy regarding pain management, which may translate to improvements in functional ability. DESIGN: This study used a pretest-post-test, quasi-experimental design. SETTING: A formal opioid management program (OMP) within a clinic associated with the University of Kentucky. PARTICIPANTS: Patients actively participating in the OMP. INTERVENTIONS: Pain neuroscience education. MAIN OUTCOME MEASURES: The Tampa Scale for Kinesiophobia-11, the Pain Self-Efficacy Questionnaire (PSEQ), and the Neurophysiology of Pain Questionnaire (NPQ) were utilized during this study. Subjects completed each questionnaire at three time points: preintervention, post-intervention, and 90 days post-intervention. RESULTS: No significant interactions between groups and the three time points were found. The a-PNE group significantly improved their knowledge between pre- and post-intervention on the NPQ and PSEQ according to paired-samples t-tests. The a-PNE group scored significantly higher at post-intervention and 90-day post-intervention than the general health education control group on the NPQ according to independent-samples t-tests. CONCLUSION: An a-PNE curriculum may be beneficial in assisting patients to understand the neurophysiology behind their pain experience. Furthermore, positive changes were noted in pain self-efficacy. The results also indicate that an a-PNE curriculum intervention was acceptable in terms of approach and understandability for the participating patients.