Unravelling the barriers to reconceptualisation of the problem in chronic pain: the actual and perceived ability of patients and health professionals to understand the neurophysiology
Moseley, G.L. (2003), J Pain 4: 184-189
Again, just the abstract. To purchased 24 hours of access would be $27,95 USD, relatively reasonable compared to the previous study. But still, that’s around $43 AUD.
Wow. Ok. This has nothing to do with providing evidence that Pain education works. It’s purely testing whether medical professionals and patients are capable of understanding pain neurophysiology. Doesn’t matter a shit whether it reduces pain or not. Clearly, he was already thinking about implementing this crap, even though there was no evidence that it worked, at this point. Its laying the groundwork.
But the important part to note that this study is also not evidence that pain education reduces pain and disability.
Here’s the study abstract:
To identify why reconceptualization of the problem is difficult in chronic pain, this study aimed to evaluate whether (1) health professionals and patients can understand currently accurate information about the neurophysiology of pain and (2) health professionals accurately estimate the ability of patients to understand the neurophysiology of pain. Knowledge tests were completed by 276 patients with chronic pain and 288 professionals either before (untrained) or after (trained) education about the neurophysiology of pain. Professionals estimated typical patient performance on the test. Untrained participants performed poorly (mean +/- standard deviation, 55% +/- 19% and 29% +/- 12% for professionals and patients, respectively), compared to their trained counterparts (78% +/- 21% and 61% +/- 19%, respectively). The estimated patient score (46% +/- 18%) was less than the actual patient score (P <.005). The results suggest that professionals and patients can understand the neurophysiology of pain but professionals underestimate patients’ ability to understand. The implications are that (1) a poor knowledge of currently accurate information about pain and (2) the underestimation of patients’ ability to understand currently accurate information about pain represent barriers to reconceptualization of the problem in chronic pain within the clinical and lay arenas.
So the study is saying that professionals and patients are very capable of understanding pain neuroscience once they’ve been trained, and professionals should not assume that patients can’t understand this information. Guess it’s not that ‘complex’ after all.
Unfortunately, health professionals have underestimated patients’ ability to understand in the past and this has been a barrier to selling millions of book…er, implementing pain neuroscience education as a therapy to help people challenged by persistent pain. This is shocking! I can’t believe that health professionals thought patients weren’t smart enough to understand pain neuroscience! It’s not like this EVER happens in the real world. We pain patients are never stigmatised and treated like we’re idiots, not ever! We’re always treated with respect and compassion. Not like we’re stupid, making it up, exaggerating or drug seeking. That just does not happen!
But I digress. The health professionals underestimated the patients’ ability to learn pain neuroscience. So Lorimer has concluded that health professionals lack of knowledge of contemporary pain neuroscience and their opinion that patients wouldn’t be able to understand it anyway, is a barrier for introducing EP to the world.
Clearly, what you then should do, is forget about all this silly ‘evidence’ stuff. Just write a book and book a world tour of seminars with cute stories and metaphors, with an entertaining stage show. It doesn’t matter that there’s no evidence that none of this actually reduces pain or disablity, that’s not whats important. What’s important is that everyone had a Really Good Time and Lorimer is a Really Great Guy who taught them all this cool stuff in funny and fun ways!
To be quite honest, Lorimer Moseley IS a brilliant presenter, He’s entertaining, charismatic, fun and funny. He’s practically a stand up comedian. But here’s the thing…do you get health advice from a stand-up comedian?
No, me neither. I’ll take the boring, staid guy at the lectern for that, thanks. The one who’s spent his time on actual science and learning, not on how to present a cute theory with no evidence and perpetuate the con of the century.
Anyway, we’re down to reference no. 4 of 12, that’s a third of the studies down. And not one of these studies has shown that pain neuroscience education reduces pain or disability.
Yet it was still let loose into the world to wreak havoc and harm on people living with severe, daily pain.