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Meta Analysis
Effectiveness of Pain Neuroscience Education in Patients with Fibromyalgia: A Systematic Review and Meta-Analysis.
- Luis Suso-Martí, Ferran Cuenca-Martínez, Patricio Alba-Quesada, Vicente Muñoz-Alarcos, Aida Herranz-Gómez, Clovis Varangot-Reille, Fernando Domínguez-Navarro, and José Casaña.
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain.
- Pain Med. 2022 Oct 29; 23 (11): 183718501837-1850.
PurposeTo assess the effects of pain neuroscience education (PNE) on patients with fibromyalgia in terms of pain intensity, fibromyalgia impact, anxiety, and pain catastrophizing.MethodsA systematic review with meta-analysis of randomized controlled trials was conducted. Standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated with RStudio software (RStudio, Boston, MA) for relevant outcomes and were pooled in a meta-analysis with the random effects model.ResultsA total of eight studies were included. The meta-analysis showed statistically significant differences in pain intensity with a moderate clinical effect in seven studies at the post-intervention assessment (SMD: -0.76; 95% CI: -1.33 to -0.19; P < 0.05) with evidence of significant heterogeneity (P < 0.05, I2 = 92%), but it did not show statistically significant differences in fibromyalgia impact, anxiety, and pain catastrophizing (P > 0.05). With regard to the follow-up assessment, only the fibromyalgia impact showed significant improvements, with a very small clinical effect in nine studies (SMD: -0.44; 95% CI: -0.73 to -0.14; P < 0.05) and evidence of significant heterogeneity (P < 0.05, I2 = 80%). After the application of a sensitivity analysis with the PNE face-to-face interventions, the meta-analysis showed a significant decrease in pain intensity, with a moderate clinical effect at the post-intervention and follow-up assessments without evidence of significant heterogeneity (P < 0.05, I2 = 10%).ConclusionsThere is low-quality evidence that in patients with fibromyalgia, PNE can decrease the pain intensity in the post-intervention period and the fibromyalgia impact in the follow-up period. However, it appears that PNE showed no effect on anxiety and pain catastrophizing.© The Author(s) 2022. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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