Exploring the impact of metaphors and pain neuroscience education on adults with chronic musculoskeletal pain.
DOI:
https://doi.org/10.59210/q0wbrm27Keywords:
Chronic pain, Musculoskeletal Pain, Metaphors, Pain Neuroscience education, Chronic Low Back PainAbstract
Background: Chronic musculoskeletal pain (CMP) is a significant global health concern. Metaphors are frequently used by people with CMP and form an integral component of pain neuroscience education (PNE). While numerous studies have explored metaphors, PNE and chronic pain, research specifically focusing on CMP remains limited.
Objectives: This study aimed to (1) identify the use and impact of metaphors in individuals with CMP, (2) critically evaluate the literature on the effectiveness of PNE in this population, and (3) explore how PNE influences individuals with CMP.
Data Sources: Nine online databases including Google Scholar, EMBASE, CINAHL, and ScienceDirect were searched from inception to 31 May 2022. Additionally, reference lists were manually searched for relevant studies.
Study Selection: Included studies comprised of randomised controlled trials (RCTs), systematic reviews, and qualitative research.
Study Appraisal and Synthesis: The selected studies were critically appraised using CASP checklists.
Results: A total of 24 studies were analysed, consisting of six systematic reviews, 11 RCTs, and seven qualitative studies. Metaphors were found to facilitate the expression and narration of pain experiences amongst individuals with CMP. The effectiveness of PNE varied depending on participants' specific conditions. Strong evidence supported PNE’s ability to reduce pain, disability, catastrophising, and kinesiophobia in individuals with chronic low back pain (CLBP). However, the evidence for its effectiveness in non-spinal pain conditions was limited and inconclusive. Reconceptualisation of pain was identified as a critical process for PNE to be effective.
Conclusions: PNE should be considered an essential intervention in the management of CLBP. Further RCTs are warranted to evaluate PNE’s efficacy in non-spinal CMP conditions and to determine its optimal delivery format.
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