Effectiveness of Pain Neuroscience Education on Chronic Pain in Diabetic Neuropathy
Article Sidebar
Main Article Content
Abstract
Background: Diabetic neuropathy, a common complication of diabetes mellitus, often leads to chronic pain, significantly impacting the quality of life. Pain Neuroscience Education (PNE) has emerged as a potential intervention to address the bio-psychosocial aspects of chronic pain. This study aimed to evaluate the effectiveness of PNE in combination with conventional therapy in reducing pain and improving the quality of life in individuals with diabetic neuropathy.
Objective: The primary objective was to assess the impact of Pain Neuroscience Education combined with conventional therapy on pain levels and quality of life in patients with diabetic neuropathy.
Methods: A randomized clinical trial was conducted with 30 participants, divided into two groups: 15 in the treatment group and 15 in the control group. Participants were recruited from neurology and physical therapy outpatient departments and selected based on specific inclusion and exclusion criteria. The treatment group received PNE and conventional therapy (TENS, stretching, and strengthening exercises), while the control group received only conventional therapy. Pain levels were assessed using the Visual Analogue Scale (VAS) at baseline and after 6 weeks of intervention.
Results: The pre-treatment VAS scores showed no significant difference between the groups (Treatment: Mean = 57.00, SD = 16.77583; Control: Mean = 56.2667, SD = 15.91705, P = 0.903). Post-treatment, the treatment group exhibited a significant reduction in pain (Mean = 19.6667, SD = 6.39940) compared to the control group (Mean = 45.3333, SD = 14.81634), with a mean difference of 25.66 and a P-value of 0.000.
Conclusion: The study demonstrated that Pain Neuroscience Education, when combined with conventional therapy, significantly reduces pain and improves the quality of life in patients with diabetic neuropathy. This suggests that PNE could be an effective component of a multi-modal approach to managing diabetic neuropathy pain.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Rondon-Ramos A, Martinez-Calderon J, Diaz-Cerrillo JL, Rivas-Ruiz F, Ariza-Hurtado GR, Clavero-Cano S, et al. Pain neuroscience education plus usual care is more effective than usual care alone to improve self-efficacy beliefs in people with chronic musculoskeletal pain: a non-randomized controlled trial. Journal of clinical medicine. 2020;9(7):2195.
Bülow K, Lindberg K, Vaegter HB, Juhl CB. Effectiveness of pain neurophysiology education on musculoskeletal pain: a systematic review and meta-analysis. Pain Medicine. 2021;22(4):891-904.
Escriche-Escuder A, Nijs J, Silbernagel KG, van Wilgen CP, Plinsinga ML, Casaña J, et al. Pain neuroscience education in persistent painful tendinopathies: A scoping review from the Tendon PNE Network. Physical Therapy in Sport. 2023.
Fernández-Gualda MÁ, Ariza-Vega P, Lozano-Lozano M, Cantarero-Villanueva I, Martín-Martín L, Castro-Martín E, et al. Persistent pain management in an oncology population through pain neuroscience education, a multimodal program: PaiNEd randomized clinical trial protocol. PloS one. 2023;18(8):e0290096.
Zimney KJ, Louw A, Cox T, Puentedura EJ, Diener I. Pain neuroscience education: Which pain neuroscience education metaphor worked best? South African Journal of Physiotherapy. 2019;75(1):1-7.
Eneberg-Boldon K, Schaack B, Joyce K. Pain neuroscience education as the foundation of interdisciplinary pain treatment. Physical Medicine and Rehabilitation Clinics. 2020;31(4):541-51.
Vicente-Mampel J, Gargallo P, Bautista IJ, Blanco-Gímenez P, de Bernardo Tejedor N, Alonso-Martín M, et al. Impact of pain neuroscience education program in community physiotherapy context on pain perception and psychosocial variables associated with it in elderly persons: a ranzomized controlled trial. International journal of environmental research and public health. 2022;19(19):11855.
Lazaridou A, Paschali M, Edwards RR. Future directions in psychological therapies for pain management. Pain Medicine. 2020;21(11):2624-6.
Ferreira PS, Corrêa LA, Bittencourt JV, Reis FJ, Meziat-Filho N, Nogueira LA. Patients with chronic musculoskeletal pain present low level of the knowledge about the neurophysiology of pain. European Journal of Physiotherapy. 2021;23(4):203-8.
Larsen JB, Skou ST, Arendt-Nielsen L, Simonsen O, Madeleine P. Neuromuscular exercise and pain neuroscience education compared with pain neuroscience education alone in patients with chronic pain after primary total knee arthroplasty: Study protocol for the NEPNEP randomized controlled trial. Trials. 2020;21(1):1-10.
Sutton CA. Pain Neuroscience Education as an Intervention for Chronic Pain. 2021.
Sillevis R, Trincado G, Shamus E. The immediate effect of a single session of pain neuroscience education on pain and the autonomic nervous system in subjects with persistent pain, a pilot study. PeerJ. 2021;9:e11543.
Peng L, Song Y, Lv B, Jing C. The effect of implementation of pain neuroscience education and rehabilitation exercise on post-operative pain and recovery after laparoscopic colorectal surgery: a prospective randomized controlled trial. Journal of Anesthesia. 2023;37(5):775-86.
Dams L, Van der Gucht E, Haenen V, Devoogdt N, Smeets A, Bernar K, et al. Effectiveness of pain neuroscience education on somatosensory functioning after surgery for breast cancer: A double‐blinded randomized controlled trial. The Anatomical Record. 2023.
Ordoñez-Mora LT, Rosero ID, Morales-Osorio MA, Guil R, Jordan GQ, Jimenez JAA, et al. NEUROCANTRIAL: study protocol for a randomised controlled trial of a pain neuroscience education programme in adults with cancer pain. BMJ open. 2023;13(9):e071493.
Nijs J, Wijma AJ, Willaert W, Huysmans E, Mintken P, Smeets R, et al. Integrating motivational interviewing in pain neuroscience education for people with chronic pain: A practical guide for clinicians. Physical Therapy. 2020;100(5):846-59.
Manfuku M, Nishigami T, Mibu A, Yamashita H, Imai R, Tanaka K, et al. Effect of perioperative pain neuroscience education in patients with post-mastectomy persistent pain: a retrospective, propensity score-matched study. Supportive Care in Cancer. 2021;29:5351-9.
Matias BA, Vieira I, Pereira A, Duarte M, Silva AG. Pain neuroscience education plus exercise compared with exercise in university students with chronic idiopathic neck pain. International Journal of Therapy And Rehabilitation. 2019;26(7):1-14.
Begum MR, Hossain MA. Validity and reliability of visual analogue scale (VAS) for pain measurement. Journal of Medical Case Reports and Reviews. 2019;2(11).
Núñez-Cortés R, Salazar-Méndez J, Calatayud J, Malfliet A, Lluch E, Mendez-Rebolledo G, et al. The optimal dose of pain neuroscience education added to an exercise programme for patients with chronic spinal pain: A systematic review and dose–response meta-analysis. Pain. 2022:10.1097.
Leake HB, Moseley GL, Stanton TR, O'Hagan ET, Heathcote LC. What do patients value learning about pain? A mixed-methods survey on the relevance of target concepts after pain science education. Pain. 2021;162(10):2558-68.
Coronado RA, Brintz CE, McKernan LC, Master H, Motzny N, Silva FM, et al. Psychologically informed physical therapy for musculoskeletal pain: current approaches, implications, and future directions from recent randomized trials. Pain reports. 2020;5(5).
Husak AJ, Bair MJ. Chronic pain and sleep disturbances: a pragmatic review of their relationships, comorbidities, and treatments. Pain Medicine. 2020;21(6):1142-52.
Mui AW, Lee AW, Lee VH, Ng W, Vardhanabhuti V, Man SS, et al. Prognostic and therapeutic evaluation of nasopharyngeal carcinoma by dynamic contrast-enhanced (DCE), diffusion-weighted (DW) magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS). Magnetic Resonance Imaging. 2021;83:50-6.