TY - JOUR
T1 - Education can reassure people with rotator cuff-related shoulder pain
T2 - a 3-arm, randomised, online experiment
AU - Zadro, Joshua R.
AU - Ferreira, Giovanni E.
AU - Muller, Ryan
AU - Sousa Filho, Luis Fernando
AU - Malliaras, Peter
AU - West, Courtney A.
AU - O'Keeffe, Mary
AU - Maher, Christopher G.
N1 - Funding Information:
This study was funded from JZ's National Health and Medical Research Council (NHMRC) Investigator Grant (APP1194105). G.F. and C.M. are also supported by NHMRC Investigator fellowships (APP2009808 and APP1194283). F.S. is supported through a scholarship provided by the Australian Government Research Training Program (RTP).
Publisher Copyright:
© 2024 Lippincott Williams and Wilkins. All rights reserved.
PY - 2024/4
Y1 - 2024/4
N2 - We aimed to investigate the immediate effect of best practice education (with and without pain science messages) and structure-focused education on reassurance among people with rotator cuff-related shoulder pain. We conducted a 3-arm, parallel-group, randomised experiment. People with rotator cuff-related shoulder pain were randomised (1:1:1) to (1) best practice education (highlights that most shoulder pain is not serious or a good indicator of tissue damage and recommends simple self-management strategies); (2) best practice education plus pain science messages (which attempt to improve understanding of pain); and (3) structure-focused education (highlighting that structural changes are responsible for pain and should be targeted with treatment). Coprimary outcomes were self-reported reassurance that no serious condition is causing their pain and continuing with daily activities is safe. Secondary outcomes measured management intentions, credibility and relevance of the education, and similarity to previous education. Two thousand two hundred thirty-seven participants were randomised and provided primary outcome data. Best practice education increased reassurance that no serious condition is causing their pain (estimated mean effect 0.5 on a 0-10 scale, 95% confidence interval [CI] 0.2-0.7) and continuing with daily activities is safe (0.6, 95% CI 0.3-0.8) compared with structure-focused education. Adding pain science messages to best practice education slightly increased both measures of reassurance (0.2, 95% CI 0.0-0.4). Clinicians treating patients with rotator cuff-related shoulder pain should highlight that most shoulder pain is not serious or a good indicator of tissue damage and recommend simple self-management strategies. The benefit of adding pain science messages is small.
AB - We aimed to investigate the immediate effect of best practice education (with and without pain science messages) and structure-focused education on reassurance among people with rotator cuff-related shoulder pain. We conducted a 3-arm, parallel-group, randomised experiment. People with rotator cuff-related shoulder pain were randomised (1:1:1) to (1) best practice education (highlights that most shoulder pain is not serious or a good indicator of tissue damage and recommends simple self-management strategies); (2) best practice education plus pain science messages (which attempt to improve understanding of pain); and (3) structure-focused education (highlighting that structural changes are responsible for pain and should be targeted with treatment). Coprimary outcomes were self-reported reassurance that no serious condition is causing their pain and continuing with daily activities is safe. Secondary outcomes measured management intentions, credibility and relevance of the education, and similarity to previous education. Two thousand two hundred thirty-seven participants were randomised and provided primary outcome data. Best practice education increased reassurance that no serious condition is causing their pain (estimated mean effect 0.5 on a 0-10 scale, 95% confidence interval [CI] 0.2-0.7) and continuing with daily activities is safe (0.6, 95% CI 0.3-0.8) compared with structure-focused education. Adding pain science messages to best practice education slightly increased both measures of reassurance (0.2, 95% CI 0.0-0.4). Clinicians treating patients with rotator cuff-related shoulder pain should highlight that most shoulder pain is not serious or a good indicator of tissue damage and recommend simple self-management strategies. The benefit of adding pain science messages is small.
KW - Advice
KW - Bursitis
KW - Rotator cuff
KW - Shoulder pain
KW - Subacromial impingement
UR - http://www.scopus.com/inward/record.url?scp=85188479525&partnerID=8YFLogxK
U2 - 10.1097/j.pain.0000000000003102
DO - 10.1097/j.pain.0000000000003102
M3 - Article
C2 - 38112759
AN - SCOPUS:85188479525
SN - 0304-3959
VL - 165
SP - 951
EP - 958
JO - Pain
JF - Pain
IS - 4
ER -