Pain Physiology Education Improves Health Status and Endogenous Pain Inhibition in Fibromyalgia: A Double-Blind Randomized Controlled Trial.
Widespread pain and central sensitization are characteristics of fibromyalgia (FM). An impaired descending nociceptive inhibition and how these mechanisms work, can be influenced by negative cognitions that have been observed in FM patients.
This study investigated the effect of pain education on pain cognitions, health status and endogenous nociceptive processing in FM patients. Pain inhibitory mechanisms were measured using spatial summation responses (SSP). Secondary outcomes include pressure pain thresholds (PPT) and several self-reported questionnaires. The experimental group received two one-on-one educational sessions about the neurophysiology of pain whereas the control received educations about activity self-management techniques. Both were delivered by a physiotherapist.
No significant effects in outcome measures were seen between the experimental and control group in baseline or after two weeks, however, scores on the Neurophysiology of Pain Test significantly increased in response to the experimental intervention. At three months follow up, the mean pain scores (SSP) in the experimental group were lower compared to the control group and there were some significant changes in health status.
Although pain physiology did not have a significant effect on SSP, it does show some positive improvements on mental health in FM patients in the long term. Further studies should examine the underlying mechanism for pain education and pain physiology as a component in the treatment of FM patients in more detail > From Oosterwijck et al., Clin J Pain (2013) (Epub ahead of print). All rights reserved to Lippincott Williams & Wilkins.
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