The influence of a pain education program on pain perception and psychosocial functioning in
patients with complex regional pain syndrome

Complex regional pain syndrome (CRPS) is a pain syndrome that can develop after
trauma or a lesion. CRPS is characterized by severe, persistent regional pain
and a combination of sensory, sudomotor, and motor/trophic manifestations. In
accordance with the FMS Guideline, we do drug, immunomodulatory, paramedical
(eg psychology, physiotherapy) and ultimately - in patients with therapy
resistance to more conventional treatments - also invasive treatments (eg
blockades, spinal cord stimulation). Despite the diverse and personalized
treatment options, an optimal result is still not achieved for every CRPS
patient; many patients continue to suffer from pain, which seriously affects
the quality of life. Previous research has shown that pain education in general
improves functioning, reduces disability and unwanted psychosocial factors,
improves exercise and reduces health care consumption. However, there is as yet
no scientific evidence for the effectiveness of pain education in patients with
CRPS. Explain Pain (EP), a pain education program set up by Moseley and Butler,
focuses on harnessing the body's bioplasticity. The hypothesis is that EP
positively influences perception and behavior by correcting incorrect
cognitions. It also influences psychological stressors such as anxiety,
depression, and catastrophizing. Indirectly, EP contributes to a positive
influence on the recovery of neuroplastic changes such as central sensitization
and cortical reorganization. In other words, EP tries to see patients see their
own pain in a different light. It is known that this takes time and that the
optimal result is permanently achieved after about a year

1. Mapping the effects of pain education on pain perception and psychosocial
functioning of patients with CRPS.
2. Further optimize the quality of care for patients with CRPS by further
exploring the possibilities of a pain education program.

Intervention research

The intervention group: The people in this group are invited to two pain
education visits at the start of the study. This takes place on two afternoons
with a week in between. Duration: approximately 2 hours per visit Then there
are additional follow-up visits after 1, 3, 6, and 12 months, with each visit
lasting 1 hour. During these check-ups, the patient receives guidance and
support in what he/she has learned. The patients are requested to bring one
close person to all visits and it is important for the investigation that this
is always the same person.

The control group: The patients in this group receive standard care as they are
used to during their visits to the pain medicine center.

Participants from both groups were asked to complete 7 questionnaires at home
at the start of the study, and after 1, 3, 6 and 12 months. The people in the
intervention group completed these questionnaires prior to each outpatient
visit. The people in the control group only have a check-up visit at the start
and the end of the study (the standard annual check-up). They also complete the
questionnaires before they come for a check-up, the other questionnaires are
completed at home after 1, 3 and 6 months without an outpatient visit. The
questions are about the severity of the pain, how the patient experiences his
or her illness, quality of life, coping with the pain and anxiety and sadness.
Completing the questionnaires will take approximately 35 minutes at a time.

Depending on the outcome of the study, the control group will receive pain
education as soon as the study has been completed. These pain education
meetings will therefore again take place in two afternoons and there will be
extra control visits in the following year.

There are no risks associated with this study other than possible short-term
emotional distress when completing the questionnaires.