Pain Neuroscience Education Training Enhances Pain Knowledge Among A Sample of Saudi Physiotherapists but does not Alter Attitudes or Beliefs

Background: Pain management for patients with chronic pain requires a comprehensive biopsychosocial approach that includes pain neuroscience education. Physiotherapists play a crucial role in delivering pain education and require a strong understanding of pain neuroscience education to enable them to tailor individual patient education, refine clinical decision-making, and potentially address central sensitization. However, limited research explores the Saudi physiotherapists' knowledge and attitudes towards pain neuroscience education. Objectives: This study investigated the impact of pain neuroscience education training on physiotherapists' knowledge, attitudes and beliefs towards working with people with chronic pain. Methods: Twenty-six physiotherapists participated in a 3-day, 21-hour intensive pain neuroscience education training program aligned with International Association for the Study of Pain (IASP) standards. The program included lectures, case studies, and group discussions led by a pain rehabilitation expert. Participants completed the Health Care Pain Attitudes and Impairment Relationship Scale (HC-PAIRS) and the Revised-Neuroscience  Pain Questionnaire (R-NPQ) before and after the training. Results: Knowledge scores (R-NPQ) significantly increased post-intervention (p < .001), with a greater number of correct responses and fewer incorrect responses. No significant changes were observed in attitudes towards chronic pain patients (HC-PAIRS, p = .99). Conclusion: This study demonstrates that a structured pain neuroscience education (PNE) training program can significantly enhance the knowledge of Saudi physiotherapists. However, it highlights a potential gap in influencing attitudes towards chronic pain patients. Future research should explore the effectiveness of multi-component interventions, including clinical supervision, to foster long-term behavioural changes aligned with biopsychosocial principles of pain management.