- Email: [email protected]
84 ACTIVE AVOIDANCE BUT NOT ACTIVITY PACING IS ASSOCIATED WITH DISABILITY IN FIBROMYALGIA
Oral Presentations / European Journal of Pain 13 (2009) S1–S54
on the irradiation day, two and four weeks later, and next, once a month. The intake of analgesics, pain level (from 0 to 10), and the QOL (EORTC QLQ-C30) were evaluated. The changes of pain levels and the particular scaling values of QLQ-C30 during a one-year period were analysed. Results: During five months, the percentage of patients using strong opioids decreased from 43.8% to 33.3%, and the percentage of patients without need of analgesics increased from 6.7% to 25%. The mean pain level decreased from 6.1 points (the irradiation day) to 3.1 points two weeks later. An inverse significant correlation between pain level and time was found. An increase was observed in five functional scales (EORTC QLQ-C30) – four of which correlated significantly with the observation time. A similar result was found for global health status. A decrease was observed in symptoms scales; six saw significant decrease, in correlation with the followup time. Correlations were found as well between pain intensity and functional scales, and between symptoms scales readings and global health status. Conclusions: HBI of cancer patients with painful multiple bone metastases is an effective and mere treatment giving significant QOL improvement and pain relief and allowing for strong analgesics uptake reduction. 82 NEUROMODULATION FOR VISCERAL PAIN – A NEW APPROACH G. Baranidharan *, K. Simpson. Pain Management Service, Leeds Teaching Hospitals NHS trust, Leeds, United Kingdom Background and aims: Spinal cord stimulation (SCS) electrodes are traditionally placed in the posterior epidural space close to the posterior columns. We describe placement of SCS electrodes in the anterior epidural space to manage visceral pain; this is a new approach to treating a difficult pain problem. Methods: We present 15 patients with chronic abdominal pain (pancreatitis, IBS and multiple surgeries), who had neuropathic pain in the abdominal dermatomes; except one patient with nociceptive renal angle pain. Either a single octrode or two quad SCS electrodes where placed percutaneously into the anterior epidural space; they required stimulation with only 10–20% of the normal voltage used for posterior leads. Results: Since October 2007 we have successfully implanted anterior SCS leads in 11/15 patients. We have devised a technique that has increased our success rate in navigating into anterior epidural space. Stimulation has been well tolerated. Electrodes where either placed in the anterior midline or antero-laterally. Traditional posterior placement only achieves 50–60% coverage; an anterior electrode covers up to 90–95%. Stimulation parameters needed were very low 0.5–4V with very low amplitude. We have revised 4/11 patients; these where all antero-lateral leads. Conclusions: Anteriorly placed SCS has been successful for this group with difficult to manage chronic abdominal pain. SCS reduced analgesic and anti-neuropathic drug requirements dramatically. SCS may prevent acute admissions; however it is not useful to manage an acute exacerbation of pain that should be fully investigated and managed using conventional techniques.
S33
Free Presentations 03: Treatment approaches (psychosocial and cognitive) 83 CAN WE SHARE A PAIN WE NEVER FELT? NEURAL CORRELATES OF EMPATHY IN PATIENTS WITH CONGENITAL INSENSITIVITY TO PAIN N. Danziger1 *, I. Faillenot2 , R. Peyron2 . 1 Department of Clinical Neurophysiology, Pain Center and INSERM U 713, Paris, France; 2 Department of Neurology, Pain Center and INSERM U342, St Etienne, France Background and Aims: Theories of empathy differ regarding the relative contributions of automatic resonance and perspective taking in understanding others’ emotions. Patients with congenital insensitivity to pain (CIP) offer a unique opportunity to explore how the lack of self-pain representation might influence the perception of others’ pain. We used event-related functional magnetic resonance imaging (fMRI) to study the neural correlates of empathy for pain in a group of 13 CIP patients, compared with a control group of 13 healthy subjects. Methods: Participants were scanned while observing body parts in painful situations or facial expressions of pain, with the instruction to imagine how the person in the picture feels. Results: Surprisingly, CIP patients showed normal responses to observed pain in anterior mid-cingulate cortex and anterior insula, two key regions of the so-called “shared circuits” for self and other pain. In these patients, but not in healthy controls, empathy trait predicted both ventro-medial prefrontal responses to viewing body parts in painful situations and posterior cingulate responses to facial expressions of pain. Conclusion: We previously showed that the ability of CIP patients to fully acknowledge the pain of others strongly depended on their empathic capacities. The present data suggest that this contribution of empathy mainly relies on the engagement of midline structures, allowing to understand someone else’s pain despite the lack of any previous personal experience of it. 84 ACTIVE AVOIDANCE BUT NOT ACTIVITY PACING IS ASSOCIATED WITH DISABILITY IN FIBROMYALGIA P.A. Karsdorp1 *, J.W.S. Vlaeyen2 . 1 Maastricht University, Maastricht, Netherlands; 2 University of Leuven, Leuven, Belgium Background and Aims: Activity pacing has been suggested as a behavioural strategy that may protect patients with fibromyalgia (FM) against activity dysregulation and disability. The aim of the present study was to examine whether the construct of activity pacing is distinct from other behavioural strategies assessed with the Chronic Pain Coping Inventory (CPCI), such as guarding, resting, asking for assistance, relaxation, task persistence exercise, seeking social support, and coping self-statements. The second objective was to test whether pacing was associated with physical disability when controlling for pain catastrophizing, pain severity and the other behavioural strategies. Methods: A random sample of patients with FM (N = 409) completed the CPCI, the Pain Catastrophizing Scale (PCS), the Physical Index of the Fibromyalgia Impact Questionnaire (FIQ-PH) and the Pain Disability Index (PDI). Results: The results demonstrated that the Dutch version of the CPCI including the pacing subscale has adequate internal consistency and construct validity. Moreover, guarding and asking for assistance, but not pacing strategies, were associated with disability. Conclusion: These findings are in line with fear-avoidance models and suggest that specifically active avoidance behaviours are detrimental in FM. The authors recommend developing cognitivebehavioural and exposure-based interventions and challenge the
S34
Oral Presentations / European Journal of Pain 13 (2009) S1–S54
idea that pacing as an intervention is essential in pain selfmanagement programs.
The results indicate a feasible intervention, the effectiveness of which is currently being tested in a RCT.
85 PREDICTORS OF LOW BACK PAIN DISABILITY M. Salvetti1 *, P´ı. Braga1 , C. Correa2 , C. Mattos Pimenta1 . 1 University of S˜ ao Paulo, S˜ ao Paulo, Brazil; 2 Hospital 9 de Julho, S˜ ao Paulo, Brazil
87 ATTITUDES AND DISABILITY IN LOW BACK PAIN PATIENTS C. Mattos Pimenta *, M. Salvetti, P´ı. Braga, G. Kurita. University of S˜ ao Paulo, S˜ ao Paulo, Brazil
Introduction: Determining predicting factors of disability in low back pain patients may help proposing preventive and rehabilitative interventions. Aims: To identify independent predictors of disability in low back pain patients. Methods: Cross-sectional study with 215 adults (outpatients and workers) recruited in S˜ao Paulo (Brazil). Participants (age 44.7±11.1 years, 65.1% female, schooling 11.2±3.5 years) filled out Socio Demographic and Clinic Profile, Oswestry Disability Index (ODI), Chronic Pain Self-Efficacy Scale, Tampa Scale for Kinesiophobia, Beck Depression Inventory, Piper Fatigue Scale and Baecke Physical Activity Questionnaire. Disability patients presented moderate or severe scores in ODI (>21) and 30 days or more of sick listed/last year. Results: Disability was observed in 53.5% (95%IC 46.6–60.3). Logistic regression identified six predictors, adjusted by sex: pain intensity (OR: 7.5; 95%CI 1.8–31.3, p = 0.005), self-efficacy (OR = 5.1; 95%CI 2.3–11.4, p < 0.001), pain fear and avoidance (OR: 3.4; 95%CI 1.5–7.5, p = 0.002), depression (OR: 3.4; 95%CI 1.4–8.3, p = 0.005), age (OR: 2.8; 95%CI 1.3–6.2, p = 0.007), and marital status (OR: 2.3; 95%CI 1.0–5.3, p = 0.047). Body mass, physical activity and fatigue do not showed significance in multiple regression analyses. Conclusions: Different beliefs and psychosocial variables were predictors of disability and it is relevant because these aspects can be changed.
Introduction: dysfunctional attitudes towards pain can lead to dysfunctional behaviors and can be related to disability. Objectives: identify potential risk factors associated with disability in low back pain. Methods: cross-sectional study developed in a pain clinic, a community clinic and factories. 215 chronic low back pain individuals were evaluated. 65.1% were female, mean age was 44.7 years (+ 11.1), the mean schooling was 11.2 years (+ 3.5) and mean pain intensity was 7.3 (+2.3). Participants answered a demographic and clinical survey, Visual Analog Scale, Oswestry Disability Index and Survey of Pain Attitudes. Relevant variables (<0.25 in univariate analysis) were then selected for multivariate analysis in a logistic regression model, in a stepwise forward procedure. Variables independently associated with the outcome and those shown to be confounding factors were kept in the final regression model adjusted for sex, age and schooling. Results: potential risk factors associated with disability among individuals with low back pain were age (OR: 2.7; 95%IC:1.3–5.8; p = 0.004), schooling (OR:3.1; 95%IC:1.4–6.9; p = 0.008), emotion related to pain (OR:1.3; 95%IC:1.0–1.7; p = 0.028), belief that pain causes disability (OR:2.5; 95%IC:1.8–3.4; p < 0.001) and belief that pain is related to physical damage (OR:1.4; 95%IC:1.0–2.0; p = 0.052). Conclusions: believe that pain causes disability and that pain is related to a physical damage were related to disability in low back pain patients. Considering that beliefs and attitudes can be changed with specific interventions, these results can guide interventions to prevent or reduce disability in low back pain.
86 WEB-BASED SITUATIONAL FEEDBACK TO SUPPORT THE USE OF POSITIVE COPING STRATEGIES IN WOMEN WITH GENERALIZED CHRONIC PAIN – A FEASIBILITY STUDY O.B. Kristjansdottir1 *, E.A. Fors2 , S. van Dulmen3 , E. Eide1,6 , A. Finset4 , S.Hø. Wigers5 , H. Eide1 . 1 Oslo University College, Oslo, Norway; 2 St. Olavs Hospital, Trondheim, Norway; 3 NIVEL, Utrecht, Netherlands; 4 University of Oslo, Oslo, Norway; 5 Jeløy Kurbad, Moss, Norway; 6 E-design, Oslo, Norway This study aimed to develop and test the feasibility of a 4 weeks contextual CBT intervention based on daily electronic diaries and individualized written feedbacks received on a Web-enabled mobile phone to intervene on pain cognitions and behavior to support coping. Six women participated and gave their assessment of the intervention in two semi-structured interviews and by filling out an evaluation questionnaire. After initial assessment with the nurse therapist (OBK or HE) the participants registered activities, emotions, pain cognitions and coping efforts three times daily. The therapists had immediate access to this information through a secure website. An SMS notified when the patients received their daily feedback. The CBT based feedback included reinforcement, information and tasks to stimulate activity and use of effective coping strategies suitable to the current situation. The experience of participating was rated as positive, supportive and meaningful by all except one who reported neutral experience. One participant dropped out after 3 weeks because of illness. The response rate regarding the diaries was 88% (441/500, drop-out excluded). More than half (4/6) considered the intervention not demanding. 50% of the feedbacks were reported helpful in staying active, 76% in staying positive. Technical problems were few. As a response to comments from participants small adjustments were made on registration forms halfway through the intervention. Results from the diaries regarding activity, catastrophizing and acceptance and examples of the feedback will be presented.
88 PAIN NEUROPHYSIOLOGY EDUCATION IMPROVES PAIN BELIEFS IN PATIENTS WITH CHRONIC FATIGUE SYNDROME: A CLINICAL EXPERIMENT M. Meeus1,2 *, J. Nijs1,2 , V. Van Alsenoy1,2 , J. Van Oosterwijck1,2 , S. Truijen1 . 1 Artesis University College Antwerp, Antwerp, Belgium; 2 Vrije Universiteit Brussel, Brussels, Belgium Background and Aims: The majority of Chronic Fatigue Syndrome (CFS) patients experience chronic pain and present abnormal pain cognitions. Educating chronic pain patients pain neurophysiology has been shown effective in improving pain cognitions, but nothing is known about the efficacy in CFS. We aimed at examining whether education on pain neurophysiology was capable of changing pain cognitions and pain thresholds in CFS patients with chronic widespread pain. Methods: Forty-eight CFS-patients with chronic pain underwent pain threshold measurements and completed questionnaires evaluating their knowledge on pain neurophysiology, coping strategies, kinesiophobia and catastrophising. Patients were randomly assigned to the experimental group (n = 24), receiving individual education on pain neurophysiology, or to the control group (n = 24) receiving an individual session on activity management. Afterwards, questionnaires and assessments were repeated by a blind assessor. Results: After the intervention, the experimental group demonstrated a significant better understanding of the neurophysiology of pain (p < 0.001), a reduction in the passive coping strategy “ruminating” (p = .011) and a decrease in the subscale “worrying” (p=.009) of the Pain Catastrophising Scale, compared to controls. For these three variables moderate to large Cohen’s d effect sizes were revealed (0.76–2.53). An increase in the active coping strategy “distraction” (p = .021) was even so revealed.
on the irradiation day, two and four weeks later, and next, once a month. The intake of analgesics, pain level (from 0 to 10), and the QOL (EORTC QLQ-C30) were evaluated. The changes of pain levels and the particular scaling values of QLQ-C30 during a one-year period were analysed. Results: During five months, the percentage of patients using strong opioids decreased from 43.8% to 33.3%, and the percentage of patients without need of analgesics increased from 6.7% to 25%. The mean pain level decreased from 6.1 points (the irradiation day) to 3.1 points two weeks later. An inverse significant correlation between pain level and time was found. An increase was observed in five functional scales (EORTC QLQ-C30) – four of which correlated significantly with the observation time. A similar result was found for global health status. A decrease was observed in symptoms scales; six saw significant decrease, in correlation with the followup time. Correlations were found as well between pain intensity and functional scales, and between symptoms scales readings and global health status. Conclusions: HBI of cancer patients with painful multiple bone metastases is an effective and mere treatment giving significant QOL improvement and pain relief and allowing for strong analgesics uptake reduction. 82 NEUROMODULATION FOR VISCERAL PAIN – A NEW APPROACH G. Baranidharan *, K. Simpson. Pain Management Service, Leeds Teaching Hospitals NHS trust, Leeds, United Kingdom Background and aims: Spinal cord stimulation (SCS) electrodes are traditionally placed in the posterior epidural space close to the posterior columns. We describe placement of SCS electrodes in the anterior epidural space to manage visceral pain; this is a new approach to treating a difficult pain problem. Methods: We present 15 patients with chronic abdominal pain (pancreatitis, IBS and multiple surgeries), who had neuropathic pain in the abdominal dermatomes; except one patient with nociceptive renal angle pain. Either a single octrode or two quad SCS electrodes where placed percutaneously into the anterior epidural space; they required stimulation with only 10–20% of the normal voltage used for posterior leads. Results: Since October 2007 we have successfully implanted anterior SCS leads in 11/15 patients. We have devised a technique that has increased our success rate in navigating into anterior epidural space. Stimulation has been well tolerated. Electrodes where either placed in the anterior midline or antero-laterally. Traditional posterior placement only achieves 50–60% coverage; an anterior electrode covers up to 90–95%. Stimulation parameters needed were very low 0.5–4V with very low amplitude. We have revised 4/11 patients; these where all antero-lateral leads. Conclusions: Anteriorly placed SCS has been successful for this group with difficult to manage chronic abdominal pain. SCS reduced analgesic and anti-neuropathic drug requirements dramatically. SCS may prevent acute admissions; however it is not useful to manage an acute exacerbation of pain that should be fully investigated and managed using conventional techniques.
S33
Free Presentations 03: Treatment approaches (psychosocial and cognitive) 83 CAN WE SHARE A PAIN WE NEVER FELT? NEURAL CORRELATES OF EMPATHY IN PATIENTS WITH CONGENITAL INSENSITIVITY TO PAIN N. Danziger1 *, I. Faillenot2 , R. Peyron2 . 1 Department of Clinical Neurophysiology, Pain Center and INSERM U 713, Paris, France; 2 Department of Neurology, Pain Center and INSERM U342, St Etienne, France Background and Aims: Theories of empathy differ regarding the relative contributions of automatic resonance and perspective taking in understanding others’ emotions. Patients with congenital insensitivity to pain (CIP) offer a unique opportunity to explore how the lack of self-pain representation might influence the perception of others’ pain. We used event-related functional magnetic resonance imaging (fMRI) to study the neural correlates of empathy for pain in a group of 13 CIP patients, compared with a control group of 13 healthy subjects. Methods: Participants were scanned while observing body parts in painful situations or facial expressions of pain, with the instruction to imagine how the person in the picture feels. Results: Surprisingly, CIP patients showed normal responses to observed pain in anterior mid-cingulate cortex and anterior insula, two key regions of the so-called “shared circuits” for self and other pain. In these patients, but not in healthy controls, empathy trait predicted both ventro-medial prefrontal responses to viewing body parts in painful situations and posterior cingulate responses to facial expressions of pain. Conclusion: We previously showed that the ability of CIP patients to fully acknowledge the pain of others strongly depended on their empathic capacities. The present data suggest that this contribution of empathy mainly relies on the engagement of midline structures, allowing to understand someone else’s pain despite the lack of any previous personal experience of it. 84 ACTIVE AVOIDANCE BUT NOT ACTIVITY PACING IS ASSOCIATED WITH DISABILITY IN FIBROMYALGIA P.A. Karsdorp1 *, J.W.S. Vlaeyen2 . 1 Maastricht University, Maastricht, Netherlands; 2 University of Leuven, Leuven, Belgium Background and Aims: Activity pacing has been suggested as a behavioural strategy that may protect patients with fibromyalgia (FM) against activity dysregulation and disability. The aim of the present study was to examine whether the construct of activity pacing is distinct from other behavioural strategies assessed with the Chronic Pain Coping Inventory (CPCI), such as guarding, resting, asking for assistance, relaxation, task persistence exercise, seeking social support, and coping self-statements. The second objective was to test whether pacing was associated with physical disability when controlling for pain catastrophizing, pain severity and the other behavioural strategies. Methods: A random sample of patients with FM (N = 409) completed the CPCI, the Pain Catastrophizing Scale (PCS), the Physical Index of the Fibromyalgia Impact Questionnaire (FIQ-PH) and the Pain Disability Index (PDI). Results: The results demonstrated that the Dutch version of the CPCI including the pacing subscale has adequate internal consistency and construct validity. Moreover, guarding and asking for assistance, but not pacing strategies, were associated with disability. Conclusion: These findings are in line with fear-avoidance models and suggest that specifically active avoidance behaviours are detrimental in FM. The authors recommend developing cognitivebehavioural and exposure-based interventions and challenge the
S34
Oral Presentations / European Journal of Pain 13 (2009) S1–S54
idea that pacing as an intervention is essential in pain selfmanagement programs.
The results indicate a feasible intervention, the effectiveness of which is currently being tested in a RCT.
85 PREDICTORS OF LOW BACK PAIN DISABILITY M. Salvetti1 *, P´ı. Braga1 , C. Correa2 , C. Mattos Pimenta1 . 1 University of S˜ ao Paulo, S˜ ao Paulo, Brazil; 2 Hospital 9 de Julho, S˜ ao Paulo, Brazil
87 ATTITUDES AND DISABILITY IN LOW BACK PAIN PATIENTS C. Mattos Pimenta *, M. Salvetti, P´ı. Braga, G. Kurita. University of S˜ ao Paulo, S˜ ao Paulo, Brazil
Introduction: Determining predicting factors of disability in low back pain patients may help proposing preventive and rehabilitative interventions. Aims: To identify independent predictors of disability in low back pain patients. Methods: Cross-sectional study with 215 adults (outpatients and workers) recruited in S˜ao Paulo (Brazil). Participants (age 44.7±11.1 years, 65.1% female, schooling 11.2±3.5 years) filled out Socio Demographic and Clinic Profile, Oswestry Disability Index (ODI), Chronic Pain Self-Efficacy Scale, Tampa Scale for Kinesiophobia, Beck Depression Inventory, Piper Fatigue Scale and Baecke Physical Activity Questionnaire. Disability patients presented moderate or severe scores in ODI (>21) and 30 days or more of sick listed/last year. Results: Disability was observed in 53.5% (95%IC 46.6–60.3). Logistic regression identified six predictors, adjusted by sex: pain intensity (OR: 7.5; 95%CI 1.8–31.3, p = 0.005), self-efficacy (OR = 5.1; 95%CI 2.3–11.4, p < 0.001), pain fear and avoidance (OR: 3.4; 95%CI 1.5–7.5, p = 0.002), depression (OR: 3.4; 95%CI 1.4–8.3, p = 0.005), age (OR: 2.8; 95%CI 1.3–6.2, p = 0.007), and marital status (OR: 2.3; 95%CI 1.0–5.3, p = 0.047). Body mass, physical activity and fatigue do not showed significance in multiple regression analyses. Conclusions: Different beliefs and psychosocial variables were predictors of disability and it is relevant because these aspects can be changed.
Introduction: dysfunctional attitudes towards pain can lead to dysfunctional behaviors and can be related to disability. Objectives: identify potential risk factors associated with disability in low back pain. Methods: cross-sectional study developed in a pain clinic, a community clinic and factories. 215 chronic low back pain individuals were evaluated. 65.1% were female, mean age was 44.7 years (+ 11.1), the mean schooling was 11.2 years (+ 3.5) and mean pain intensity was 7.3 (+2.3). Participants answered a demographic and clinical survey, Visual Analog Scale, Oswestry Disability Index and Survey of Pain Attitudes. Relevant variables (<0.25 in univariate analysis) were then selected for multivariate analysis in a logistic regression model, in a stepwise forward procedure. Variables independently associated with the outcome and those shown to be confounding factors were kept in the final regression model adjusted for sex, age and schooling. Results: potential risk factors associated with disability among individuals with low back pain were age (OR: 2.7; 95%IC:1.3–5.8; p = 0.004), schooling (OR:3.1; 95%IC:1.4–6.9; p = 0.008), emotion related to pain (OR:1.3; 95%IC:1.0–1.7; p = 0.028), belief that pain causes disability (OR:2.5; 95%IC:1.8–3.4; p < 0.001) and belief that pain is related to physical damage (OR:1.4; 95%IC:1.0–2.0; p = 0.052). Conclusions: believe that pain causes disability and that pain is related to a physical damage were related to disability in low back pain patients. Considering that beliefs and attitudes can be changed with specific interventions, these results can guide interventions to prevent or reduce disability in low back pain.
86 WEB-BASED SITUATIONAL FEEDBACK TO SUPPORT THE USE OF POSITIVE COPING STRATEGIES IN WOMEN WITH GENERALIZED CHRONIC PAIN – A FEASIBILITY STUDY O.B. Kristjansdottir1 *, E.A. Fors2 , S. van Dulmen3 , E. Eide1,6 , A. Finset4 , S.Hø. Wigers5 , H. Eide1 . 1 Oslo University College, Oslo, Norway; 2 St. Olavs Hospital, Trondheim, Norway; 3 NIVEL, Utrecht, Netherlands; 4 University of Oslo, Oslo, Norway; 5 Jeløy Kurbad, Moss, Norway; 6 E-design, Oslo, Norway This study aimed to develop and test the feasibility of a 4 weeks contextual CBT intervention based on daily electronic diaries and individualized written feedbacks received on a Web-enabled mobile phone to intervene on pain cognitions and behavior to support coping. Six women participated and gave their assessment of the intervention in two semi-structured interviews and by filling out an evaluation questionnaire. After initial assessment with the nurse therapist (OBK or HE) the participants registered activities, emotions, pain cognitions and coping efforts three times daily. The therapists had immediate access to this information through a secure website. An SMS notified when the patients received their daily feedback. The CBT based feedback included reinforcement, information and tasks to stimulate activity and use of effective coping strategies suitable to the current situation. The experience of participating was rated as positive, supportive and meaningful by all except one who reported neutral experience. One participant dropped out after 3 weeks because of illness. The response rate regarding the diaries was 88% (441/500, drop-out excluded). More than half (4/6) considered the intervention not demanding. 50% of the feedbacks were reported helpful in staying active, 76% in staying positive. Technical problems were few. As a response to comments from participants small adjustments were made on registration forms halfway through the intervention. Results from the diaries regarding activity, catastrophizing and acceptance and examples of the feedback will be presented.
88 PAIN NEUROPHYSIOLOGY EDUCATION IMPROVES PAIN BELIEFS IN PATIENTS WITH CHRONIC FATIGUE SYNDROME: A CLINICAL EXPERIMENT M. Meeus1,2 *, J. Nijs1,2 , V. Van Alsenoy1,2 , J. Van Oosterwijck1,2 , S. Truijen1 . 1 Artesis University College Antwerp, Antwerp, Belgium; 2 Vrije Universiteit Brussel, Brussels, Belgium Background and Aims: The majority of Chronic Fatigue Syndrome (CFS) patients experience chronic pain and present abnormal pain cognitions. Educating chronic pain patients pain neurophysiology has been shown effective in improving pain cognitions, but nothing is known about the efficacy in CFS. We aimed at examining whether education on pain neurophysiology was capable of changing pain cognitions and pain thresholds in CFS patients with chronic widespread pain. Methods: Forty-eight CFS-patients with chronic pain underwent pain threshold measurements and completed questionnaires evaluating their knowledge on pain neurophysiology, coping strategies, kinesiophobia and catastrophising. Patients were randomly assigned to the experimental group (n = 24), receiving individual education on pain neurophysiology, or to the control group (n = 24) receiving an individual session on activity management. Afterwards, questionnaires and assessments were repeated by a blind assessor. Results: After the intervention, the experimental group demonstrated a significant better understanding of the neurophysiology of pain (p < 0.001), a reduction in the passive coping strategy “ruminating” (p = .011) and a decrease in the subscale “worrying” (p=.009) of the Pain Catastrophising Scale, compared to controls. For these three variables moderate to large Cohen’s d effect sizes were revealed (0.76–2.53). An increase in the active coping strategy “distraction” (p = .021) was even so revealed.