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Returning to Work After Breast Cancer Surgery: A Randomised Controlled Trial on the Effect of Pain Neuroscience Education

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Abstract

Purpose: The aim of this study was to investigate the effect of pain neuroscience education compared to biomedical pain education after breast cancer surgery on (1) work status, (2) time until work resumption, and (3) change in return-to-work expectations up to 18 months post-surgery. Methods: Participants were randomly assigned to either pain neuroscience education (intervention group) or biomedical pain education (control group) in addition to a standard physical therapy program after surgery for breast cancer. The first four months following surgery, one to two physiotherapy sessions and three educational sessions were scheduled. After, two educational sessions and two physiotherapy sessions were held at six and eight months postoperatively. All outcomes were assessed at four, six, eight, 12 and 18 months postoperatively. Results: At 12 months, in the intervention group, 71% of the women returned to work compared to 53% in the control group (18% points difference, 95%CI:-0.1 to 35;p = 0.07). At 18 months, the differences decreased to 9% points, 95%CI:-26 to 7;p = 0.35). Neither time until work resumption (p = 0.46) nor change in estimation of own ability to return to work up to 18 months postoperatively (p = 0.21) significantly differed between both groups. Conclusion: No significant differences were found regarding return to work outcomes between women receiving pain neuroscience education versus biomedical pain education after breast cancer surgery. Further research is warranted to explore the potential role of pain neuroscience education in return-to-work interventions following breast cancer surgery.

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Data Availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Funding

The study is funded by Research Foundations – Flanders (FWO) (T005117N).

Author information

Authors and Affiliations

  1. Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, MOVANT, Antwerp, Belgium

    An De Groef, Tessa De Vrieze, Mira Meeus & Lore Dams

  2. Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium

    An De Groef, Elien Van der Gucht, Nele Devoogdt, Tessa De Vrieze & Lore Dams

  3. Pain In Motion International research group. http://www.paininmotion.be, Antwerp, Belgium

    An De Groef, Elien Van der Gucht, Mira Meeus & Lore Dams

  4. Department of Vascular Surgery, Department of Physical Medicine and Rehabilitation, Center for Lymphedema, UZ Leuven - University Hospitals Leuven, Leuven, Belgium

    Nele Devoogdt

  5. Department of Surgical Oncology, University Hospitals Leuven, Leuven, Belgium

    Ann Smeets

  6. The Leuven Centre for Algology and Pain Management, University Hospitals Leuven, Leuven, Belgium

    Koen Bernar & Bart Morlion

  7. Department of Cardiovascular Sciences, Section Anaesthesiology and Algology, KU Leuven - University of Leuven, Leuven, Belgium

    Bart Morlion

  8. Centre for Environment and Health, University of Leuven, Leuven, Belgium

    Lode Godderis

  9. IDEWE, External Service for Prevention and Protection at Work, Leuven, Belgium

    Lode Godderis

  10. Interuniversity Center for Biostatistics and Statistical Bioinformatics, University of Leuven and University of Hasselt, Leuven, Belgium

    Steffen Fieuws

  11. Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium

    Mira Meeus

  12. Department of Rehabilitation Sciences and Physiotherapy, KU Leuven, ON4 – Herestraat 49 – box 1510, Leuven, 3000, Belgium

    An De Groef

Authors
  1. An De Groef
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Contributions

An De Groef, Nele Devoogdt, Ann Smeets, Bart Morlion, Lode Godderis and Mira Meeus conceived and designed the study and analyses;

Elien Van der Gucht, Lore Dams and Koen Bernar collected the data;

An De Groef, Elien Van der Gucht, Steffen Fieuws and Lore Dams performed the analyses;

An De Groef, Elien Van der Gucht and Lore Dams wrote the first version of the paper.

All co-authors reviewed and approved the final manuscript.

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Correspondence to An De Groef.

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Competing Interests

All authors have completed the ICMJE uniform disclosure form (available on request from the corresponding author) and declare: no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work. Bart Morlio has served as a consultant for Reckitt-Benekiser, Grunenthal, Pfizer, GSK, and as a speaker for Grunenthal, Krka, GSK Belgium.

Ethics Approval

This study was performed in line with the principles of the Declaration of Helsinki. The study was approved by the Ethical Committee of the University Hospitals Leuven (s60702).

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Informed consent was obtained from all individual participants included in the study.

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De Groef, A., Van der Gucht, E., Devoogdt, N. et al. Returning to Work After Breast Cancer Surgery: A Randomised Controlled Trial on the Effect of Pain Neuroscience Education. J Occup Rehabil 33, 757–765 (2023). https://doi.org/10.1007/s10926-023-10103-9

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