Can pain beliefs change in middle school students? A study of the effectiveness of pain neuroscience education

Pain neuroscience education (PNE) is an educational strategy aimed at teaching people more about pain from a neurobiological and neurophysiological perspective. Current best-evidence provides strong support for PNE to positively influence pain ratings, dysfunctions, fear-avoidance and pain catastrophization, limitations in movement, pain knowledge, and healthcare utilization. To date, all PNE studies have been conducted on adult populations. This study set out to explore if an abbreviated PNE lecture to middle school children would result in a positive shift in pain knowledge as well as healthier beliefs regarding pain. One-hundred-and-thirty-three middle school students spanning 5th to 8th grade attended a 30-minute PNE lecture. The primary outcome measures of pain knowledge (neurophysiology of pain questionnaire [NPQ]) and beliefs regarding pain (numeric rating scale) were measured before and immediately after the PNE lecture. Significant improvement in knowledge was found with mean score on NPQ test scores improving from 3.83 (29.5%) pre-PNE to 7.90 (60.8%) post-PNE (p<0.001), with a large effect size (r=.711). Significant shifts in beliefs were also found in all but one of the pain beliefs questions, with a medium effect size for you can control how much pain you feel (p<0.001; r=0.354) and large effect size for your brain decides if you feel pain, not your tissues (p<0.001; r=0.545). This study shows that a 30-minute PNE lecture to middle school children resulted in a significant increase in their knowledge of pain as well various beliefs regarding pain.