A Modern Pain Neuroscience Approach in Patients Undergoing Surgery for Lumbar Radiculopathy: A Clinical Perspective

Phys Ther. 2019 Jul 1;99(7):933-945. doi: 10.1093/ptj/pzz053.

Abstract

Around 20% of patients undergoing surgery for lumbar radiculopathy develop chronic pain after surgery, leading to high socioeconomic burden. Current perioperative interventions, including education and rehabilitation, are not always effective in preventing prolonged or chronic postoperative pain and disability. Here, a shift in educational intervention from a biomedical towards a biopsychosocial approach for people scheduled for lumbar surgery is proposed. Pain neuroscience education (PNE) is a biopsychosocial approach that aims to decrease the threat value of pain by reconceptualizing pain and increasing the patient's knowledge about pain. This paper provides a clinical perspective for the provision of perioperative PNE, specifically developed for patients undergoing surgery for lumbar radiculopathy. Besides the general goals of PNE, perioperative PNE aims to prepare the patient for postsurgical pain and how to cope with it.

MeSH terms

  • Chronic Pain / psychology*
  • Chronic Pain / rehabilitation*
  • Humans
  • Low Back Pain / surgery*
  • Neurosciences
  • Pain Management / methods*
  • Pain Measurement
  • Pain, Postoperative / psychology*
  • Pain, Postoperative / rehabilitation*
  • Patient Education as Topic
  • Radiculopathy / surgery*