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Master Thesis

Intérêt de l'éducation neurophysiologique à la douleur chez le patient lombalgique chronique

Abstract : Introduction: We have always associated pain with an injury, but what happens when it becomes chronic? In this regard, a recent recommendation by the HAS recognises the interest of bio-psycho-social management of chronic low back pain patients. Pain neurophysiology education (PNE) is part of this approach and aims to normalise the patient's beliefs about pain. According to previous studies, it could lead to a reduction in chronic pain. Objective: To assess the potential benefit in terms of pain, functional disability, and attitudes and beliefs towards pain of providing pain neurophysiology education (PNE) for patients with chronic low back pain. Material and methods: A search was conducted on five databases (PubMed, Cochrane, PEDro, Kinedoc, Google Scholar). Five randomised clinical trials matching the inclusion criteria were analysed. Results: PNE would significantly and possibly clinically decrease pain and catastrophizing. The results are still uncertain concerning kinesiophobia, but it would globally lead to a normalisation of beliefs towards pain. Regarding functional disability, it seems to improve it in the medium term but not in a clinical way. Discussion: The studies compare the addition of PNE with various therapeutic techniques, which may enhance or attenuate its effect. Moreover, the samples size is not large enough to obtain precise results and the effects are only noted in the short and medium term. It would be interesting to have long-term results to see if this therapeutic education leads to a change in the patient's habits. Given its low cost and lack of side effects, it remains interesting to provide in our current practice. Conclusion: A normalisation of the patient's beliefs brought about by the PNE would seem to be interesting to reduce pain and catastrophism in the short and medium term. Regarding functional disability and kinesiophobia, more in-depth studies with more participants are needed. Training of physiotherapists in the neuroscience of pain remains interesting in order to remain in line with the latest scientific recommendations.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03358641
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Submitted on : Wednesday, September 29, 2021 - 2:56:48 PM
Last modification on : Friday, October 8, 2021 - 3:26:32 AM

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Anaëlle Savi. Intérêt de l'éducation neurophysiologique à la douleur chez le patient lombalgique chronique. Médecine humaine et pathologie. 2021. ⟨dumas-03358641⟩

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