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. 2021 Jun;29(3):158-167.
doi: 10.1080/10669817.2020.1821327. Epub 2020 Sep 15.

Embedding pain neuroscience education in the physical therapy management of patients with chronic plantar fasciitis: a prospective case series

Katherine M Mills  1 , Emily B Preston  1 , Breanna M Choffin Schmitt  1 , Haley K Brochu  1 , Eden A Schafer  1 , Payton E Robinette  1 , Emma K Sterling  1 , Rogelio A Coronado  1
Affiliations

Embedding pain neuroscience education in the physical therapy management of patients with chronic plantar fasciitis: a prospective case series

Katherine M Mills et al. J Man Manip Ther. 2021 Jun.

Abstract

Objectives: The purpose of this case series was to describe the effects of a biopsychosocial approach that embeds pain neuroscience education (PNE) within physical therapy for improving foot and ankle function, pain, and psychosocial factors in patients with chronic plantar fasciitis.

Methods: Seven female patients (mean [SD] age = 49.0 [11.4] years) receiving physical therapy for chronic plantar fasciitis were enrolled. Along with formal physical therapy, patients received six 15-minute PNE sessions. Knowledge of pain neuroscience was assessed before and after PNE with the Revised Neurophysiology of Pain Questionnaire. Patients completed questionnaires for foot and ankle function (Activities of Daily Living subscale of the Foot and Ankle Ability Measure), pain intensity (Numeric Rating Scale), pain catastrophizing (Pain Catastrophizing Scale), and fear of movement (Tampa Scale for Kinesiophobia) at baseline (before treatment) and 6 and 12 weeks. Local and remote pain sensitivity was assessed using a pressure algometer at baseline and 6 weeks.

Results: Patients attended a mean (range) of 8.7 (7 to 12) physical therapy sessions over a mean (range) of 46.7 (42 to 56) days. After PNE, six (86%) patients demonstrated increased knowledge of pain neuroscience. At 12 weeks, six (86%) patients met or exceeded minimally clinically important difference (MCID) for foot and ankle function and pain. Five (71%) patients met or exceeded MCID for pain catastrophizing and fear of movement. Local pain sensitivity was reduced in six (86%) patients.

Conclusions: Physical therapy integrating PNE is potentially beneficial for patients with chronic plantar fasciitis. Future studies should examine the efficacy of PNE in randomized trials with larger representative samples.

Keywords: Chronic pain; musculoskeletal pain; pain management; pain neuroscience education; physical therapy modalities; plantar fasciitis.

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Conflict of interest statement

No potential conflict of interest was reported by the authors.

Figures

Figure 1.
Figure 1.
Correlogram depicting associations (p < 0.10) between change in patient-reported outcomes, knowledge of pain neuroscience, psychosocial measures, and pain sensitivity from baseline to 6 weeks. Values are correlation coefficients
Figure 2.
Figure 2.
Correlogram depicting associations (p < 0.10) between change in patient-reported outcomes and psychosocial measures from baseline to 12 weeks. Values are correlation coefficients
See this image and copyright information in PMC

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