Archives of Physical Medicine and Rehabilitation
Volume 91, Issue 8 , Pages 1153-1159, August 2010

Pain Physiology Education Improves Pain Beliefs in Patients With Chronic Fatigue Syndrome Compared With Pacing and Self-Management Education: A Double-Blind Randomized Controlled Trial

Presented to the World Confederation of Physical Therapy, June 2–6, 2007, Vancouver, Canada; the International Council on Physiotherapy in Psychiatry and Mental Health, February 27–29, 2008, Bergen University, Norway; the European Society of Physical and Rehabilitation Medicine, June 3–6, 2008, Bruges, Belgium; the International Federation of Orthopaedic Manipulative Therapists, June 9–13, 2008, Rotterdam, The Netherlands; and the European Federation of International Association for the Study of Pain Chapters, September 8–12, 2009, Lisbon, Portugal.

  • Mira Meeus, PhD

      Affiliations

    • Division of Musculoskeletal Physiotherapy, Department of Health Sciences, Artesis University College, Antwerp, Belgium
    • Department of Human Physiology, Faculty of Physical Education and Physiotherapy, Vrije Universiteit, Brussels, Belgium
    • ,
  • Jo Nijs, PhD

      Affiliations

    • Division of Musculoskeletal Physiotherapy, Department of Health Sciences, Artesis University College, Antwerp, Belgium
    • Department of Human Physiology, Faculty of Physical Education and Physiotherapy, Vrije Universiteit, Brussels, Belgium
    • Department of Rehabilitation and Physiotherapy, University Hospital, Brussels, Belgium
    • Corresponding Author InformationReprint requests to Jo Nijs, PhD, Artesis Hogeschool Antwerpen, Dept of Health Sciences, Division of Musculoskeletal Physiotherapy, Van Aertselaerstraat 31, 2170 Merksem, Belgium
    • ,
  • Jessica Van Oosterwijck, PT

      Affiliations

    • Division of Musculoskeletal Physiotherapy, Department of Health Sciences, Artesis University College, Antwerp, Belgium
    • Department of Human Physiology, Faculty of Physical Education and Physiotherapy, Vrije Universiteit, Brussels, Belgium
    • Department of Rehabilitation and Physiotherapy, University Hospital, Brussels, Belgium
    • ,
  • Veerle Van Alsenoy, PT

      Affiliations

    • Division of Musculoskeletal Physiotherapy, Department of Health Sciences, Artesis University College, Antwerp, Belgium
    • ,
  • Steven Truijen, PhD

      Affiliations

    • Division of Musculoskeletal Physiotherapy, Department of Health Sciences, Artesis University College, Antwerp, Belgium

Abstract 

Meeus M, Nijs J, Van Oosterwijck J, Van Alsenoy V, Truijen S. Pain physiology education improves pain beliefs in patients with chronic fatigue syndrome compared with pacing and self-management education: a double-blind randomized controlled trial.

Objective

To examine whether pain physiology education was capable of changing pain cognitions and pain thresholds in patients with chronic fatigue syndrome (CFS) and chronic widespread pain.

Design

Double-blind randomized controlled trial.

Setting

Specialized chronic fatigue clinic in university hospital.

Participants

A random sample of patients (N=48) with CFS patients (8 men, 40 women) experiencing chronic pain, randomly allocated to the control group (n=24) or experimental group (n=24). Two women in the experimental group did not complete the study because of practical issues (lack of time and restricted mobility).

Interventions

One individual pain physiology education session (experimental) or 1 pacing and self-management education session (control).

Main Outcome Measures

Algometry, the Neurophysiology of Pain Test, and questionnaires evaluating pain cognitions—the Pain Coping Inventory, the Pain Catastrophizing Scale, and the Tampa Scale for Kinesiophobia–version CFS—were completed immediately before and immediately after the intervention.

Results

After the intervention, the experimental group demonstrated a significantly better understanding of the neurophysiology of pain (P<.001) and a reduction of the Pain Catastrophizing Scale subscale “ruminating” (P=.009) compared with controls. For these variables, moderate to large Cohen d effect sizes were revealed (.79–2.53).

Conclusions

A 30-minute educational session on pain physiology imparts a better understanding of pain and brings about less rumination in the short term. Pain physiology education can be an important therapeutic modality in the approach of patients with CFS and chronic pain, given the clinical relevance of inappropriate pain cognitions.

Key Words: Fatigue syndrome, chronic, Patient education as topic, Pain threshold, Questionnaires, Rehabilitation

List of Abbreviations: CFS, chronic fatigue syndrome, CLBP, chronic low back pain, PCI, Pain Coping Inventory, PCS, Pain Catastrophizing Scale

 

 Supported by the Higher Institute of Physiotherapy, Department of Health Sciences, Artesis University College Antwerp, Belgium (grant no. G 807), the Faculty of Physical Education and Physiotherapy—Vrije Universiteit Brussel, Brussels, Belgium (OZR project OZ.R. 1234/MFYS Wer2), and a postdoctoral research fellowship of the Research Foundation Flanders—Fonds Wetenschappelijk Onderzoek (FWO).

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

PII: S0003-9993(10)00251-0

doi:10.1016/j.apmr.2010.04.020

Archives of Physical Medicine and Rehabilitation
Volume 91, Issue 8 , Pages 1153-1159, August 2010

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