Pain Management, Sport Injuries, Volleyball Player
Conditions
Keywords
pain neuroscience education, volleybal player, shoulder pain
Brief summary
This randomized controlled study investigated the effects of pain neuroscience education (PNE) on pain intensity, pain knowledge, and pain catastrophizing in elite volleyball players with chronic shoulder pain. Participants were assigned to either a PNE group or a control group, both continuing regular sports training, while the PNE group additionally received six weeks of structured education sessions.
Detailed description
This study represents a theory-informed intervention examining chronic shoulder pain in elite athletes from a modern pain science perspective. Instead of focusing solely on peripheral tissue pathology, the research is grounded in the biopsychosocial model of pain, emphasizing the role of central pain processing, pain beliefs, and maladaptive cognitive responses such as catastrophizing. In high-level volleyball players, where repetitive overhead loading and performance demands often lead athletes to continue training despite persistent symptoms, pain may become strongly influenced by cognitive and educational factors. Within this context, the study investigates whether modifying the understanding and interpretation of pain through Pain Neuroscience Education (PNE) can influence both the sensory and cognitive dimensions of the pain experience. Methodologically, the study was designed as a prospective randomized controlled trial. Elite volleyball players with chronic shoulder pain were randomly allocated to either an education-based intervention group or a control group. Both groups maintained their regular sports training routines, ensuring that any observed effects could be attributed to the educational intervention rather than changes in physical load. The intervention consisted of a structured six-week PNE program delivered in repeated sessions, focusing on explaining pain mechanisms, central sensitization, and the non-linear relationship between tissue damage and pain. Outcomes were selected to reflect both physical and cognitive domains of pain: pain intensity, pain-related knowledge, and pain catastrophizing were measured before and after the intervention period to evaluate multidimensional changes associated with the educational approach.
Interventions
OTHERPain neuroscience education
Pain Neuroscience Education is an educational intervention aimed at improving individuals' understanding of the neurophysiological mechanisms underlying pain. The education focuses on contemporary pain science concepts, including the role of the central nervous system, pain modulation, central sensitization, and the distinction between tissue damage and pain perception. The PNE program was delivered through structured sessions using verbal explanations, visual materials, metaphors, and examples relevant to daily life and sports activities. The content emphasized that pain is a protective output of the nervous system rather than a direct indicator of tissue injury, and that psychological, cognitive, and contextual factors can influence pain intensity and persistence. Participants were encouraged to reconceptualize pain, reduce maladaptive beliefs and fear related to movement, and develop a more adaptive understanding of their pain experience. The education was tailored to elite volley
Sponsors
Pamukkale University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
This study used a parallel-group randomized controlled design. Eligible participants were randomly allocated to either the pain neuroscience education (PNE) group or the control group. Both groups continued their regular sports training programs, while the intervention group additionally received a structured six-week PNE program. Outcome measures were assessed at baseline and after completion of the intervention.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Being an elite volleyball player actively competing in a professional club * Experiencing shoulder and/or arm pain for at least three months * Providing voluntary informed consent to participate in the study
Exclusion criteria
* Participating in volleyball at an amateur level * Presence of pain in regions other than the shoulder and arm * History of cancer or pregnancy * Pain originating from neurological, cardiogenic, or rheumatological conditions * Failure to complete the pain neuroscience education (PNE) program
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual analog scale | From enrollment to the end of treatment at 6 weeks" | The Visual Analog Scale is a unidimensional tool used to assess pain intensity. Participants rate their perceived pain by marking a point on a 10-cm (or 100-mm) horizontal line, with higher scores indicating greater pain intensity. |
| Revised Pain Neurophysiology Questionnaire (R-PNQ) | From enrollment to the end of treatment at 6 weeks | Revised Pain Neurophysiology Questionnaire (R-PNQ) The R-PNQ is a 12-item questionnaire designed to assess individuals' knowledge of the biology and physiology of pain based on contemporary pain science. Each item is answered as true, false, or undecided. Correct responses are scored as one point, yielding a total score ranging from 0 to 12, with higher scores indicating greater pain neurophysiology knowledge. A validated Turkish version of the questionnaire was used. |
| Pain Catastrophizing Scale (PCS) | From enrollment to the end of treatment at 6 weeks | The PCS is a 13-item self-report questionnaire used to evaluate maladaptive cognitive and emotional responses to pain. It consists of three subscales: rumination, magnification, and helplessness. Higher scores reflect greater levels of pain catastrophizing |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORAziz DENGİZ, Assist. Prof.
Muş Alparslan University
STUDY_DIRECTORHarun KOÇ, Assist. Prof.
Muş Alparslan University
Outcome results
None listed