Abstract
This article explores the effectiveness of a newly developed Pain Neuroscience Education program for children (PNE4Kids) with functional abdominal pain disorder (FAPD). Children (6–12 years) with FAPD were randomly assigned to 1) the experimental group (n = 14), participating in one hypnotherapy session (i.e., usual care) and one additional PNE4Kids session, or 2) the control group (n = 14), participating in two hypnotherapy sessions. Parental pain catastrophizing, the child’s functional disability (parental-proxy), pain-related fear (parent-proxy) and pain intensity, were assessed at baseline and one and three weeks after each therapy session. Pressure algometry and a conditioned pain modulation paradigm were performed at baseline and three weeks after completion of the last therapy session. Parents from both the experimental as well as the control group showed significantly less parental pain catastrophizing (p < 0.01). Children showed significantly less functional disability (p < 0.05), pain-related fear (p < 0.01) and local pressure pain sensitivity (p < 0.05) at short-term follow-up (three weeks after last intervention) in both groups. No significant (p > 0.05) between-group differences were found. Hypnotherapy combined with PNE4Kids did not result in better clinical outcomes compared to hypnotherapy alone. Study limitations include the application of one single PNE4Kids session and the short follow-up time.
Highlights
Functional Abdominal Pain Disorders (FAPDs) are prevalent in up to 13.5% of children and adolescents and have a significant impact on their health-related quality of life as well as their physical, academic and social activities and exposes children at a higher risk to the development of chronic pain and depressive symptoms later in life [1,2,3,4]
The present study examined whether children with FAPD and their parents receiving PNE4Kids in addition to standard care would help improve parental pain catastrophizing and child’s functional disability when compared to a group receiving only standard care
A total of 28 children with FAPD were included in the study and received either two sessions of hypnotherapy or either a combination of one session of hypnotherapy usual care and one session of PNE4Kids (Figure 1)
Summary
Functional Abdominal Pain Disorders (FAPDs) are prevalent in up to 13.5% of children and adolescents and have a significant impact on their health-related quality of life as well as their physical, academic and social activities and exposes children at a higher risk to the development of chronic pain and depressive symptoms later in life [1,2,3,4]. Current pain management in adolescents and in children with persistent pain often includes an educational component [7] This psychoeducation is focused on psychological aspects related to pain and on pain management strategies rather than on an explanation of the pain science, including underlying biological mechanisms of pain [8]. It might be counterintuitive to patients (and parents) to advise them to adopt certain behaviors (i.e., resuming physical, social, and school activities) without decreasing the threat value of pain first. Pain Neuroscience Education (PNE) (1) includes a thorough explanation of pain science; (2) aims to reassure patients (and parents) by decreasing the threat value of pain; and (3) includes the integral role of psychosocial and physical factors in precipitating and maintaining pain. PNE has been used in various adult chronic pain populations and has been shown to be effective in changing pain beliefs (i.e., pain catastrophizing) and pain coping strategies, improving disability, pain intensity, and health status [12,13]
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