Pain Neuroscience Education in Myofascial Pain Syndrome

Summary

Background This study aimed to evaluate the additive effect of Pain Neuroscience Education (PNE), which addresses the biopsychosocial and neurophysiological foundations of pain, on conventional physiotherapy in myofascial pain syndrome (MPS).

Methods Forty individuals with MPS aged between 18-50 years participated in the study. The participants were divided into two groups as study group (n=20) and control group (n=20). The control group received a conventional physiotherapy and rehabilitation program three times a week 6 weeks. In the Study group, PNE was given once a week for 6 weeks in addition to the conventional physiotherapy and rehabilitation programme. Short Form Mc-Gill Pain Questionnaire (SF-MPQ), Algometer, Pain Catastrophising Scale (PCS), Tampa Scale of Kinesiophobia (TSK) and Depression-Anxiety-Stress Scale (DASS), Pittsburg Sleep Quality Index (PSQI) and Myotonometry were used in the evaluation.

Conditions

• Myofascial Pain Syndromes
• Neuroscience Pain Education
• Physical Therapy Modalities

Interventions

OTHER

Conventional physiotherapy

Transcutaneous electrical nerve stimulation (TENS); The negative electrode was placed on the trigger point and the positive electrode was placed on the insertion of the acromial tendon of the trapezius muscle. Conventional type TENS with a frequency of 50-100 Hz and a current duration of 100 μsec was applied for 20 minutes by adjusting the current intensity to the value that the patient could tolerate. US; Chattanooga® (Mexico) with 1.5 Watt/ cm² current intensity, 1 MHz frequency and continuous mode was applied to the right and left sides for 4 minutes each. It was performed by drawing circles on the trigger point and surrounding tissues with the US probe. HP; was applied for 20 minutes to the area covering the muscle with trigger point and surrounding tissues

OTHER

Exercise

An exercise programme consisting of stretching exercises for tense muscles which are effective in the formation of Myofascial Pain Syndrome (MPS) and trunk stabilisation exercises to provide deep postural muscle activation was applied. Abdominal hallowing exercise, shoulder bridge exercise, swimming exercise and stretching exercises were performed as 10 repetitions. In addition, scapular stabilisation exercises were also included in the programme because myofascial pain often leads to immobilisation. The 6-week exercise programme was planned to be progressively revised every 2 weeks. In this case, other extremities were included, new exercises were added, and progressive difficulty level was provided with the help of a medicine ball or resistance band. Patients were asked to perform this exercise programme, which was applied in the clinic, at home once a day for 10 repetitions. Whether the exercises were performed regularly at home was followed up with verbal feedback

OTHER

Pain neuroscience education (PNE)

Pain Neuroscience Education (PNE) was delivered to the study group through individual, face-to-face sessions focusing on pain neurophysiology. The content was based on the book Explain Pain and supported by a PowerPoint presentation incorporating metaphors, examples, and visual materials to enhance comprehension. Considering reduced attention span in individuals with chronic pain, PNE was provided once weekly for 6 weeks, with each session lasting approximately 15 minutes, resulting in a total duration of 90 minutes. Conventional physiotherapy interventions were initiated immediately after each PNE session. Patients were encouraged to ask questions during treatment to reinforce the educational content through their own pain experiences and to promote active engagement in subsequent sessions.

Sponsors & Collaborators

• Istinye University

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

TRIPLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

65 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2022-06-10

Primary Completion

2023-07-01

Completion

2023-07-10

Countries

• Turkey (Türkiye)

Study Locations