Pain Neuroscience Education for Children with Functional Abdominal Pain Disorders: A Randomized Comparative Pilot Study

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.

Talking to Children and Families about Chronic Pain: The Importance of Pain Education—An Introduction for Pediatricians and Other Health Care Providers

“…To educate patients and their families about pain can be one component of a comprehensive treatment program or also serve as a stand-alone intervention. Several approaches and modes of delivering pain education have been researched in the past (for a review see [ 25 , 32 ]), proven to be a successful intervention in adults [ 33 ], and are often used in children [ 31 ], but with a rather limited evidence base in the pediatric pain context so far [ 34 ].…”

The effect of a pain educational video intervention upon child pain‐related outcomes: A randomized controlled study

“…The current best evidence on PNE supports its beneficial effects in terms of reduced pain ratings (Louw et al, 2011(Louw et al, , 2016, pain-related fear (Moseley & Butler, 2015), pain catastrophizing (Louw et al, 2011;Moseley & Butler, 2015), healthcare use (Louw et al, 2016) and enhanced pain knowledge (Louw et al, 2016) in adults with a wide range of chronic pain states. Preliminary evidence in children demonstrated converging findings, with pain educational interventions resulting in increased pain knowledge (Andias et al, 2018;Louw et al, 2018;Wager et al, 2018), less painrelated fear (Pas et al, 2020), less local pressure pain sensitivity (Pas et al, 2020) and more functional pain beliefs (Louw et al, 2018) within both clinical and non-clinical settings. However, findings on the effectiveness of pain educational interventions in children are scarce and null effects in both adults and children were observed as well (e.g.…”

Do Parental Pain Knowledge, Catastrophizing, and Hypervigilance Improve Following Pain Neuroscience Education in Healthy Children?

“…One recent study investigated the effectiveness of PNE4Kids in combination with hypnotherapy in children with FAPD [20]. The scores on the Pain Catastrophizing Scale-Parent (PCS-P), the Faces Pain Scale-Revised (FPS-R), pressure algometry, and conditioned pain modulation obtained from the group who received the combination of the two therapies did not reach statistical signification when compared to the scores obtained by the group who received hypnotherapy alone.…”

“…PNE4Kids is a PNE program that has recently been developed for children aged 6-12 years old and uses an interactive board game to explain pain science to children [5,6]. PNE4Kids has been tested in children suffering from functional abdominal pain disorders (FAPD), showing that a combination of a single session of PNE4Kids and hypnotherapy was able to reduce parental pain catastrophizing and improve children's functional disability [20]. During the PNE4kids session, the influence of pain beliefs, cognitions, and behaviors on the child's pain is discussed.…”

“…This intent of parent involvement might have led to improved parental outcomes, such as parental pain-related attitudes, protective behavior in response to their child's pain, and perceptions of the child's functioning [6,7,15,17]. A better understanding of their child's pain may lead to adequate parental supportive behavior based on the rationale that the child's pain behaviors can be driven by their parents or the caregivers [20]. Thus, it is crucial to include parents or caregivers as part of the prevention process and track potential changes in their pain behavior.…”