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Pain Neuroscience Education, Chronic Pain, and Health Care
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Pain Neuroscience Education, Chronic Pain, and Health Care

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 21003

Special Issue Editors

Prof. Dr. César Fernández De Las Peñas

E-Mail Website
Chief Guest Editor
Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Madrid, Spain
Interests: chronic pain; pain neuroscience education, manual therapy; central nervous system sensitization
Special Issues, Collections and Topics in MDPI journals
Dr. Emilio Puentedura

E-Mail Website
Assistant Guest Editor
Doctor of Physical Therapy Program, Robbins College of Health and Human Services, Baylor University, Waco, Texas 76706, USA
Interests: chronic pain; pain neuroscience education, manual therapy; central nervous system sensitization

Special Issue Information

Dear Colleagues,

 The biopsychosocial model includes the application of pain neuroscience education (PNE) to a multimodal treatment approach for the management of chronic pain conditions. PNE is applied to the management of disability associated with chronic pain and to address inappropriate nocebo beliefs. It is also believed that PNE may be useful in the prevention of chronic pain by improving beliefs and addressing fear about pain. Additionally, education can be also applied to promoting healthy lifestyle habits within the general population. This Special Issue targets the topic of PNE from a broad perspective, including proper management of chronic pain conditions but also health care promotion and prevention. Any group investigating PNE is encouraged to submit to this Special Issue.

Dr. César Fernández-de-las-Peñas
Dr. Emilio Puentedura
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • chronic pain
  • pain neuroscience education
  • physical therapy
  • treatment
  • motor imagery
  • graded exposure

Published Papers (5 papers)

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Research

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7 pages, 669 KiB  
Article
Pain Intensity and Sensory Perception of Tender Points in Female Patients with Fibromyalgia: A Pilot Study
by Edurne Úbeda-D'Ocasar, Juan Antonio Valera-Calero, Juan Pablo Hervás-Pérez, Mario Caballero-Corella, Cristina Ojedo-Martín and Gracia María Gallego-Sendarrubias
Int. J. Environ. Res. Public Health 2021, 18(4), 1461; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18041461 - 04 Feb 2021
Cited by 17 | Viewed by 3641
Abstract
Fibromyalgia syndrome (FMS) is a condition that courses with chronic pain, fatigue, sleep disturbance, impaired quality of life and daily function. Due to the lack of blood, imaging or histological confirmatory tests, the diagnosis of FMS is based on the presence of widespread [...] Read more.
Fibromyalgia syndrome (FMS) is a condition that courses with chronic pain, fatigue, sleep disturbance, impaired quality of life and daily function. Due to the lack of blood, imaging or histological confirmatory tests, the diagnosis of FMS is based on the presence of widespread pain and presence of tender points (TPs). Our aim was to assess the pain pressure thresholds (PPTs) and subjective pain perception (SPP) of all 18 TPs while applying a normalized pressure in female patients with fibromyalgia. An exploratory descriptive pilot study was conducted in 30 female patients with FMS. Sociodemographic data (e.g., age, height, weight, and body mass index), clinical characteristics (e.g., years with diagnosis and severity of FMS), PPTs (assessed with an algometer), and SPP (assessed with a visual analogue scale) of all 18 TPs were collected. A comparative analysis side-to-side (same TP, left and right sides) and between TPs was conducted. No side-to-side differences were found (p < 0.05). Significant differences between all 18 TPs were found for PPTs (p < 0.0001), and SPP (p < 0.005) scores were found. The most mechanosensitive points were located in the second costochondral junction, the occiput, the trochanteric prominence; the most painful while applying a normalized pressure considering the TP and side were those located in the gluteus, trochanteric prominence, and supraspinatus. The current study describes PPTs and SPP, as assessed with algometry and visual analogue scale, respectively, of all 18 TPs in female patients with FMS. TPs exhibited significant PPTs and SPP differences between TP locations with no side-to-side differences. Full article
(This article belongs to the Special Issue Pain Neuroscience Education, Chronic Pain, and Health Care)
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23 pages, 1710 KiB  
Article
Behavior Change Following Pain Neuroscience Education in Middle Schools: A Public Health Trial
by Adriaan Louw, Regina Landrus, Jessie Podolak, Patricia Benz, Jen DeLorenzo, Christine Davis, Alison Rogers, Kathy Cooper, Colleen Louw, Kory Zimney, Emilio J. Puentedura and Merrill R. Landers
Int. J. Environ. Res. Public Health 2020, 17(12), 4505; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17124505 - 23 Jun 2020
Cited by 13 | Viewed by 5378
Abstract
Chronic pain and the opioid epidemic need early, upstream interventions to aim at meaningful downstream behavioral changes. A recent pain neuroscience education (PNE) program was developed and tested for middle-school students to increase pain knowledge and promote healthier beliefs regarding pain. In this [...] Read more.
Chronic pain and the opioid epidemic need early, upstream interventions to aim at meaningful downstream behavioral changes. A recent pain neuroscience education (PNE) program was developed and tested for middle-school students to increase pain knowledge and promote healthier beliefs regarding pain. In this study, 668 seventh-grade middle-school students either received a PNE lecture (n = 220); usual curriculum school pain education (UC) (n = 198) or PNE followed by two booster (PNEBoost) sessions (n = 250). Prior to, immediately after and at six-month follow-up, pain knowledge and fear of physical activity was measured. Six months after the initial intervention school, physical education, recess and sports attendance/participation as well as healthcare choices for pain (doctor visits, rehabilitation visits and pain medication use) were measured. Students receiving PNEBoost used 30.6% less pain medication in the last 6 months compared to UC (p = 0.024). PNEBoost was superior to PNE for rehabilitation visits in students experiencing pain (p = 0.01) and UC for attending school in students who have experienced pain > 3 months (p = 0.004). In conclusion, PNEBoost yielded more positive behavioral results in middle school children at six-month follow-up than PNE and UC, including significant reduction in pain medication use. Full article
(This article belongs to the Special Issue Pain Neuroscience Education, Chronic Pain, and Health Care)
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9 pages, 1042 KiB  
Article
Myalgia in 30 Patients with Suspected Myopathy
by Diana Lehmann Urban, Elizabeth Lehmann, Leila Motlagh Scholle and Torsten Kraya
Int. J. Environ. Res. Public Health 2020, 17(7), 2502; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17072502 - 06 Apr 2020
Viewed by 2498
Abstract
Background: In patients with neuromuscular disorder, only little data of myalgia frequency and characterization exists. To date, only a weak correlation between pain intensity and pressure pain threshold has been found, and it remains enigmatic whether high pain intensity levels are equivalent to [...] Read more.
Background: In patients with neuromuscular disorder, only little data of myalgia frequency and characterization exists. To date, only a weak correlation between pain intensity and pressure pain threshold has been found, and it remains enigmatic whether high pain intensity levels are equivalent to high pain sensitivity levels in neuromuscular disorders. Methods: 30 sequential patients with suspected neuromuscular disorder and myalgia were analyzed with regard to myalgia characteristics and clinical findings, including symptoms of depression and anxiety and pain- threshold. Results: A neuromuscular disorder was diagnosed in 14/30 patients. Muscular pain fasciculation syndrome (MPFS) without evidence for myopathy or myositis was diagnosed in 10/30 patients and 6/30 patients were diagnosed with pure myalgia without evidence for a neuromuscular disorder (e.g., myopathy, myositis, MPFS, polymyalgia rheumatica). Highest median pain scores were found in patients with pure myalgia and polymyalgia rheumatica. Pressure pain threshold measurement showed a significant difference between patients and controls in the biceps brachii muscle. Conclusion: Only a weak correlation between pain intensity and pressure pain threshold has been suggested, which is concordant with our results. The hypothesis that high pain intensity levels are equivalent to high pain sensitivity levels was not demonstrated. Full article
(This article belongs to the Special Issue Pain Neuroscience Education, Chronic Pain, and Health Care)
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Review

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15 pages, 880 KiB  
Review
Is Irritable Bowel Syndrome Considered in Clinical Trials on Physical Therapy Applied to Patients with Temporo-Mandibular Disorders? A Scoping Review
by Daiana P. Rodrigues-de-Souza, Javier Paz-Vega, César Fernández-de-las-Peñas, Joshua A. Cleland and Francisco Alburquerque-Sendín
Int. J. Environ. Res. Public Health 2020, 17(22), 8533; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17228533 - 17 Nov 2020
Cited by 2 | Viewed by 2143
Abstract
The aim of the current scoping review was to identify if the presence of irritable bowel syndrome was included as eligibility criteria of participants included in clinical trials investigating the effects of physical therapy in individuals with temporomandibular pain disorders (TMDs). A systematic [...] Read more.
The aim of the current scoping review was to identify if the presence of irritable bowel syndrome was included as eligibility criteria of participants included in clinical trials investigating the effects of physical therapy in individuals with temporomandibular pain disorders (TMDs). A systematic electronic literature search in the Web of Science database was conducted. Scientifically relevant, randomized clinical trials (those cited in other studies at least 5 times, or clinical trials published in high-impact journals, i.e., first and second quartiles (Q1-Q2) of any category of the Journal Citation Report (JCR)) evaluating the effects of any physical therapy intervention in patients with TMDs were included. The Physiotherapy Evidence Database (PEDro) scale was used to evaluate the methodological quality of the selected trials. Authors affiliated to a clinical or non-clinical institution, total number of citations, objective, sex/gender, age, and eligibility criteria in each article were extracted and analyzed independently by two authors. From a total of 98 identified articles, 12 and 19 clinical trials were included according to the journal citation criterion or JCR criterion, respectively. After removing duplicates, a total of 23 trials were included. The PEDro score ranged from 4 to 8 (mean: 6.26, SD: 1.48). Based on the eligibility criteria of the trials systematically reviewed, none considered the presence of comorbid irritable bowel syndrome in patients with TMDs. The comorbidity between TMDs and irritable bowel syndrome is not considered within the eligibility criteria of participants in highly cited clinical trials, or published in a high-impact journal, investigating the effects of physical therapy in TMDs. Full article
(This article belongs to the Special Issue Pain Neuroscience Education, Chronic Pain, and Health Care)
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Other

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11 pages, 572 KiB  
Case Report
Physician-Delivered Pain Neuroscience Education for Opioid Tapering: A Case Report
by Vikas Agarwal, Adriaan Louw and Emilio J. Puentedura
Int. J. Environ. Res. Public Health 2020, 17(9), 3324; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17093324 - 11 May 2020
Cited by 2 | Viewed by 6472
Abstract
We describe the case of a 75-year-old female with chronic low back pain (CLBP), on opioids for more than 15 years. She presented with an acute episode of nausea, vomiting, abdominal pain, and shortness of breath. After a complete work-up, it was concluded [...] Read more.
We describe the case of a 75-year-old female with chronic low back pain (CLBP), on opioids for more than 15 years. She presented with an acute episode of nausea, vomiting, abdominal pain, and shortness of breath. After a complete work-up, it was concluded that her presenting symptoms were likely due to her high levels of CLBP and high dose opioids. At the time of intervention, her opioid dosage was between 50–90 MME (Morphine milligram equivalent) (Norco 8 × 7.5 mg/day + Fentanyl 12 mcg patch). She was subsequently seen by the physician for seven outpatient internal medicine appointments over nine months and received Pain Neuroscience Education (PNE) in conjunction with monitored tapering of opioids and other medication associated with her CLBP. This case report demonstrates how a physician might deliver PNE as a viable nonpharmacological treatment option for the tapering of long-term opioids for chronic pain. Full article
(This article belongs to the Special Issue Pain Neuroscience Education, Chronic Pain, and Health Care)
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