Papers of the Week

Pain science education can be used as part of treatment and prevention for chronic pain in children. We assessed the effectiveness of pain science education on knowledge, beliefs, attitudes, and behaviors in children and the people that care for children. We set a minimum criterion for education to address pain biology knowledge. We included studies aimed at both treatment and prevention of chronic pain. We conducted searches using five databases. We assessed the risk of bias using the Cochrane Risk of Bias 2 tool. Data were pooled using a random-effects meta-analysis or assessed using a narrative synthesis. The certainty of evidence was assessed using the GRADE. We screened 14505 records and included seven studies involving 351 caregivers and 1285 children. Four studies were included in meta-analyses. We found low certainty evidence that PSE has a large beneficial effect on caregiver knowledge and beliefs compared to alternative education (SMD=1.14 (95%CI: 0.88 to 1.42; I²=0%). We found no difference in functional disability in children with chronic pain after PSE (FDI score MD=0.73 (95%CI: -0.81 to 2.27; I=0%). Narrative syntheses showed low certainty evidence for improved knowledge and beliefs in children with preventative and treatment effects. Overall we found few studies, and along with high risk of bias, this significantly contributed to the low certainty of findings. The effect of learning pain science for both preventative and treatment effects in children, carers and the child/carer dyad remain mostly unknown. This review was prospectively registered with PROSPERO (CRD42022344382) on 22 July 2022. PERSPECTIVE: This review examines the effect of pain science education (PSE) on pain-related knowledge, beliefs, attitudes, and behaviors in children and the people that care for children (0-18). The findings contribute to knowledge about pain treatments and health promotion for caregivers of children with and without chronic pain. Clear recommendations for improving the quality of evidence in future studies are outlined.