An exploration of the extent and nature of reconceptualisation of pain following pain neurophysiology education: A qualitative study of experiences of people with chronic musculoskeletal pain.

Abstract

OBJECTIVE: Pain neurophysiology education (PNE), a method of pain education, purports to work by helping patients reconceptualise their pain, shifting from a tissue injury model towards a biopsychosocial understanding related to neural sensitivity. Better understanding of pain reconceptualisation following PNE is needed to improve the delivery of this educational approach to enhance its effectiveness. This study aimed to investigate the extent and nature of reconceptualisation following PNE. METHODS: In a qualitative design, based on Interpretive Phenomenological Analysis, thematic analysis was carried out on individual interviews with 7 adults before and three weeks after receiving PNE at a pain clinic. RESULTS: Three themes emerged describing variable degrees of reconceptualisation; prior beliefs as facilitators and barriers to reconceptualisation; and the influence of reconceptualisation on clinical benefits of PNE. CONCLUSION: The results lend support to claims that reconceptualisation is an important mechanism in PNE and justify further investigation of this phenomenon. PRACTICAL IMPLICATIONS: When delivering PNE to patients with chronic pain helping patients to reconceptualise their pain may be key to enhancing the clinical benefits of the intervention. Understanding prior beliefs may be an important step in facilitating reconceptualisation.