Preoperative pain neuroscience education for shoulder surgery: A case series.
Adriaan Louw, Debra Rico, Leigh Langerwerf and 3 others
PMID 32935067WHAT IT FOUND
In 12 patients awaiting shoulder surgery, one session of pain education did not reduce pain ratings.
It did increase pressure pain threshold at the operated shoulder and reduce fear of movement, though the fear reduction was smaller than the minimal clinical difference.
Key findings
01Pain ratings did not significantly decrease after the education session.
02Pressure pain threshold at the operated shoulder significantly increased, exceeding the minimal clinically important difference.
03Fear of movement scores significantly decreased, but the average change did not meet the minimal detectable change.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was a case series with no control group, so it cannot determine if the changes were due to the education or natural variation. The sample size was very small (12 patients), limiting the reliability of the findings. Outcomes were measured only immediately after the session, with no long-term follow-up to see if effects persisted after surgery. The central sensitisation inventory was only measured before the intervention, so changes in this specific cognitive profile were not tracked.
Declared interests
No specific funding sources or conflicts of interest are declared in the provided text.
The easy way to misread this
Do not interpret the statistically significant changes in fear of movement or range of motion as clinically meaningful for the average patient, as the mean improvements did not meet the minimal detectable change thresholds.