Pain Neuroscience Education and Motor Imagery-Based Exercise Protocol May Reduce Pain Intensity for Patients With Fibromyalgia

In a randomized controlled study, researchers found that pain neuroscience education (PNE) and motor imagery-based exercise protocol (MIEP) reduced pain intensity among patients with fibromyalgia and chronic back pain.

Chronic pain conditions such as fibromyalgia often present substantial challenges for clinicians, as patients commonly experience debilitating pain accompanied by psychological distress. Traditional treatment approaches may fall short, highlighting the need for innovative strategies. This study addresses a gap in understanding how PNE and MIEP can influence pain perception and associated psychosocial factors, providing insights that could enhance patient management.

The researchers divided participants (N = 50) divided into four groups: MIEP (n = 12), PNE (n = 12), MIEP + PNE (n = 14), and a control group (n = 12). Pain intensity was the primary outcome measured using the Visual Analog Scale (VAS), while secondary measures included beliefs, kinesiophobia, anxiety–depression, cognitive mood, self-esteem, and body awareness. Participants were assessed before and after the intervention period, allowing for a comparison of outcomes across the different treatment modalities.

Results showed that participants in all experimental groups experienced reductions in pain intensity, with no group demonstrating superior effectiveness over the others. Participants in the MIEP + PNE group achieved a mean reduction in pain intensity (95% CI, −4.7078 to −0.9922, P = .003), while those in the MIEP group also showed improvements (95% CI, −5.4806 to −1.0194, P = .003). The PNE group reported a similar decrease (95% CI, −3.6139 to −1.5461, P = .002). Additionally, improvements in organic beliefs were observed in both groups receiving PNE, with the MIEP + PNE group showing enhanced beliefs (95% CI, −7.8211 to −0.3189, P = .017) and the PNE group alone indicating similar positive changes (95% CI, −9.7999 to −0.0401, P = .003). The MIEP + PNE group exhibited superior organic pain beliefs compared to the control group (95% CI, 1.7241–9.4959, P = .008).

The study’s limitations include a small sample size and lack of long-term follow-up data. The absence of blinding in the study design could also introduce bias in the self-reported outcomes.

“According to this study, in which MIEP and PNE were combined, there was a decrease in pain intensity when both applications were applied together and when they were applied one by one,” the study authors concluded.

Reference

Kircali S, Özcan ÖÖ, Karahan M. Pain neuroscience education and motor imagery-based exercise protocol for patients with fibromyalgia. Brain Behav. 2024;14(9):e70013. doi: 10.1002/brb3.70013