Abstract
Chronic pain and the opioid epidemic need early, upstream interventions to aim at meaningful downstream behavioral changes. A recent pain neuroscience education (PNE) program was developed and tested for middle-school students to increase pain knowledge and promote healthier beliefs regarding pain. In this study, 668 seventh-grade middle-school students either received a PNE lecture (n = 220); usual curriculum school pain education (UC) (n = 198) or PNE followed by two booster (PNEBoost) sessions (n = 250). Prior to, immediately after and at six-month follow-up, pain knowledge and fear of physical activity was measured. Six months after the initial intervention school, physical education, recess and sports attendance/participation as well as healthcare choices for pain (doctor visits, rehabilitation visits and pain medication use) were measured. Students receiving PNEBoost used 30.6% less pain medication in the last 6 months compared to UC (p = 0.024). PNEBoost was superior to PNE for rehabilitation visits in students experiencing pain (p = 0.01) and UC for attending school in students who have experienced pain > 3 months (p = 0.004). In conclusion, PNEBoost yielded more positive behavioral results in middle school children at six-month follow-up than PNE and UC, including significant reduction in pain medication use.
Highlights
Three variables were associated with school attendance (p < 0.001) (Table 5); the variance explained was only 6.4% (R2 = 0.64). These results suggest that longer duration of pain at the intervention, knowing someone with chronic pain, and improved score on pain knowledge before and after the intervention were associated with more days missed from school in the 6 months following the interventions
Three variables were significantly associated with physical education (PE) participation (p < 0.001) and explained 6.8% of the variance in PE participation (Table 5). These results suggest that being a girl, having longer duration of pain, and having more fear avoidance beliefs were associated with more missed days from PE at school in the subsequent 6 months from the interventions
The biggest positive finding of the study is that the students in the PNEBoost group used significantly less pain medication in the subsequent school year compared to the usual care (UC) group
Summary
The main goals of this study were to examine the efficacy of three different educational models
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