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

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Mills, KM; Preston, EB; Choffin Schmitt, BM; Brochu, HK; Schafer, EA; Robinette, PE; Sterling, EK; Coronado, RA

Published Date

  • June 2021

Published In

Volume / Issue

  • 29 / 3

Start / End Page

  • 158 - 167

PubMed ID

  • 32933452

Pubmed Central ID

  • PMC8183540

Electronic International Standard Serial Number (EISSN)

  • 2042-6186

International Standard Serial Number (ISSN)

  • 1066-9817

Digital Object Identifier (DOI)

  • 10.1080/10669817.2020.1821327

Language

  • eng