Background

Pain is one of the most prevalent and debilitating symptom following cancer treatment.

Objectives

This paper entails a practical guide for clinicians willing to apply pain neuroscience education (PNE) in this specific population, or clinical researchers willing to examine the effects of PNE in patients suffering from pain following cancer.

Results

Patient-specific information (i.e. beliefs, cognitions, pain memories, social factors) as well as identification of the dominant pain mechanism are needed to tailor the education to the specific needs and beliefs of the patient. Therapists require an in-depth understanding of pain mechanisms, the skills to explain to their patients various pain mechanisms, specific communication skills (e.g. Socratic-style dialogof education) and experience with current evidence-based biopsychosocially-driven pain management strategies for successful implementation of PNE in the clinic. Rather than purely focusing on the biomedical characteristics of pain following cancer (e.g., tissue damage due to past cancer treatment), PNE implies teaching patients about the underlying biopsychosocial mechanisms of pain. Its application is backed-up by mounting evidence supporting the effectiveness of PNE in non-cancer pain populations, and a pilot study in patients having pain following cancer.

Conclusion

PNE is a potential solution to improve pain outcome in cancer survivors. Further research using sufficiently powered and well-designed randomized clinical trials should be conducted to examine the potential of PNE in patients having pain following cancer.

中文翻译：

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解释癌症后的疼痛：临床医生实用指南。

背景

疼痛是癌症治疗后最普遍且最令人衰弱的症状之一。

目标

本文为愿意在这一特定人群中应用疼痛神经科学教育 (PNE) 的临床医生或愿意检查 PNE 对癌症后疼痛患者的影响的临床研究人员提供了实用指南。

结果

需要患者特定的信息（即信仰、认知、疼痛记忆、社会因素）以及主要疼痛机制的识别，以便根据患者的特定需求和信仰定制教育。治疗师需要深入了解疼痛机制、向患者解释各种疼痛机制的技能、特定的沟通技巧（例如苏格拉底式教育对话）以及当前基于证据的生物心理社会驱动的疼痛管理策略的经验，以成功实施PNE 在诊所。PNE 并不是纯粹关注癌症后疼痛的生物医学特征（例如，过去癌症治疗造成的组织损伤），而是意味着向患者传授疼痛的潜在生物心理社会机制。越来越多的证据支持 PNE 对非癌症疼痛人群的有效性，以及一项针对癌症后疼痛患者的试点研究，支持了其应用。

结论

PNE 是改善癌症幸存者疼痛结果的潜在解决方案。应使用足够有力且设计良好的随机临床试验进行进一步研究，以检验 PNE 在癌症后疼痛患者中的潜力。