The effectiveness of Pain Neuroscience Education (PNE) on pain and quality of life among patients with Fibromyalgia (FM): A structured literature review.

Abstract

Abstract Background: Fibromyalgia (FM) syndrome is a common musculoskeletal disease characterised mainly by chronic widespread pain, general fatigue, stiffness, thermal hyperalgesia and sleep disturbance, with psychological features such as anxiety and depression. Growing evidence suggest the use of Pain Neuroscience Education (PNE) with chronic pain patients, and encouraging results have been shown with FM patients specifically. The aim of this structured literature review is to evaluate the current available evidence on the effectiveness of PNE on FM patients’ quality of life, pain intensity and pain catastrophizing. Methods: Six electronic databases, namely MEDLINE, PubMed, CENTRAL, AMED, CINAHL and PEDro, were searched between May 2021 and June 2021 for relevant RCTs that met the inclusion criteria. The studies were screened and the PEDro scale was used to evaluate their methodological quality. Results: The search yielded 347 articles, five of which met the inclusion criteria and achieved “good” quality scores using the PEDro scale. These studies involved a total number of 520 FM patients, the majority of whom were female. All of the studies evaluated patients’ quality of life, pain intensity, and pain catastrophizing before and after receiving PNE. Conclusion: The included studies suggested the use of PNE to improve the quality of life of FM patients and to reduce their pain and pain catastrophizing. Higher dosages of PNE showed better results in pain intensity. Additionally, using PNE as part of a multicomponent treatment have shown promising results. PNE delivered only in written form seemed to miss the essence of the therapist-patient interaction to reconceptualise the patient’s pain beliefs, which undermined the required effect of PNE. Further studies are advocated to investigate the proper dosage, rhythm and methods of delivery to reach the optimal results from PNE.