Pain ManagementNCT07393347
Pain Neuroscience Education for the Management of Chronic Pain in Elite Volleyball Players With Chronic Shoulder Pain
A study testing Pain neuroscience education in people with Pain Management and Sport Injuries, run by Pamukkale University at 1 site in Turkey (Türkiye).
Trial 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. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Pain Management, Sport Injuries, Volleyball Player
- What is being tested?
- Pain neuroscience education
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 40 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 3 Dec 2025to 16 Jan 2026
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- 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
Who cannot join
- 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
Trial locations and contacts
1 site in 1 country.
Turkey (Türkiye)1 site
Muş Alparslan University, Faculty of Sport Sciences
Muş, 49100
About this study
Official title: Pain Neuroscience Education for the Management of Chronic Pain in Elite Volleyball Players With Chronic Shoulder Pain: A Randomized Controlled Trial
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.
Read the 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.
- Conditions
- Pain Management, Sport Injuries, Volleyball Player
- Being tested
- Pain neuroscience education
- Keywords
- pain neuroscience education, volleybal player, shoulder pain
- Medical subject headings
- Agnosia, Shoulder Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Pain neuroscience educationOther
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
| Study group | Role | What they receive |
|---|---|---|
| Pain Neuroscience group | Experimental | Participants assigned to this arm received pain neuroscience education (PNE) in addition to their regular sports training program. The PNE intervention was delivered over six weeks, with two sessions per week, each lasting approximately 45 minutes, and focused on the neurobiology and neurophysiology of pain, pain mechanisms, and the relationship between pain and tissue damage. Receives: Other: Pain neuroscience education |
| Control group | No intervention | Participants in the control group continued their regular sports training programs throughout the study period and did not receive pain neuroscience education or any additional educational or therapeutic intervention related to pain management. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Visual analog scale
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.
Measured: From enrollment to the end of treatment at 6 weeks"
Revised Pain Neurophysiology Questionnaire (R-PNQ)
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.
Measured: From enrollment to the end of treatment at 6 weeks
Pain Catastrophizing Scale (PCS)
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
Measured: From enrollment to the end of treatment at 6 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 Feb 2026
- Study start3 Dec 2025
- Primary completion15 Jan 2026
- Study completion16 Jan 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (10)Papers the sponsor has linked to this study.
- Other trials for Pain ManagementStudies of the same condition, open and under way.
- More trials run by Pamukkale UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- 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.
- Masking
- None (open label)
- Enrolment
- 40 participants (actual)
Sponsor and investigators
- Lead sponsor
- Pamukkale University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Aziz DENGİZ, Pamukkale University
- Investigators
- Aziz DENGİZ, Assist. Prof., Principal investigator, Muş Alparslan UniversityHarun KOÇ, Assist. Prof., Study director, Muş Alparslan University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07393347
- Sponsor's protocol ID
- valleybollPNE
- Status last verified
- Jan 2026
- First submitted
- 23 Jan 2026
- Last updated
- 6 Feb 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Sullivan MJ, Bishop SR, Pivik J. Pain catastrophizing scale. Psychol Assess. 1995;7(4):524-532.
Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken). 2011 Nov;63 Suppl 11:S240-52. doi: 10.1002/acr.20543. No abstract available.
PubMed 22588748Catley MJ, O'Connell NE, Moseley GL. How good is the neurophysiology of pain questionnaire? A Rasch analysis of psychometric properties. J Pain. 2013 Aug;14(8):818-27. doi: 10.1016/j.jpain.2013.02.008. Epub 2013 May 4.
PubMed 23651882Sastre-Munar A, Romero-Franco N. Pain Education in the Wellness, Training Performance, and Pain Intensity of Youth Athletes: An Experimental Study. Healthcare (Basel). 2024 Jan 16;12(2):215. doi: 10.3390/healthcare12020215.
PubMed 38255102Sanchez-Robalino A, Sinchi-Sinchi H, Ramirez A. Effectiveness of Pain Neuroscience Education in Physical Therapy: A Systematic Review and Meta-Analysis. Brain Sci. 2025 Jun 18;15(6):658. doi: 10.3390/brainsci15060658.
PubMed 40563828Cuenca-Martinez F, Suso-Marti L, Calatayud J, Ferrer-Sargues FJ, Munoz-Alarcos V, Alba-Quesada P, Bivia-Roig G. Pain neuroscience education in patients with chronic musculoskeletal pain: an umbrella review. Front Neurosci. 2023 Nov 24;17:1272068. doi: 10.3389/fnins.2023.1272068. eCollection 2023.
PubMed 38075271Gajardo-Burgos R, Valdebenito-Tejos C, Galvez-Garcia G, Bascour-Sandoval C. Pain and Psychological Readiness to Return to Sport in Elite Volleyball Players: A Cross-Sectional Study. Int J Environ Res Public Health. 2023 Jan 30;20(3):2492. doi: 10.3390/ijerph20032492.
PubMed 36767858Alaiti RK, Reis FJJ. Pain in Athletes: Current Knowledge and Challenges. Int J Sports Phys Ther. 2022 Oct 1;17(6):981-983. doi: 10.26603/001c.37675. eCollection 2022. No abstract available.
PubMed 36237643Malfliet A, Leysen L, Pas R, Kuppens K, Nijs J, Van Wilgen P, Huysmans E, Goudman L, Ickmans K. Modern pain neuroscience in clinical practice: applied to post-cancer, paediatric and sports-related pain. Braz J Phys Ther. 2017 Jul-Aug;21(4):225-232. doi: 10.1016/j.bjpt.2017.05.009. Epub 2017 May 19.
PubMed 28579013Koc H, Dengiz A. Pain neuroscience education for the management of chronic pain in elite volleyball players with chronic shoulder pain: a randomized controlled trial. BMC Sports Sci Med Rehabil. 2026 Apr 20;18(1):257. doi: 10.1186/s13102-026-01698-6.
PubMed 42002795
Study at a glance
From the registry record, last updated by the sponsor on 6 Feb 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Pain Neuroscience Education for the Management of Chronic Pain in Elite Volleyball Players With Chronic Shoulder Pain: A Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07393347
- Acronym / sponsor ID
- valleybollPNE
- Conditions
- Pain Management, Sport Injuries, Volleyball Player
- Keywords
- pain neuroscience education, volleybal player, shoulder pain
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 40 participants (actual)
- Lead sponsor
- Pamukkale UniversityUniversity, hospital or other
- Study start
- 3 Dec 2025 (actual)
- Primary completion
- 15 Jan 2026 (actual)
- Study completion
- 16 Jan 2026 (actual)
- First posted
- 6 Feb 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
- 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.
| Arm | Type | Receives |
|---|---|---|
| Pain Neuroscience group | Experimental | Other: Pain neuroscience educationParticipants assigned to this arm received pain neuroscience education (PNE) in addition to their regular sports training program. The PNE intervention was delivered over six weeks, with two sessions per week, each lasting approximately 45 minutes, and focused on the neurobiology and neurophysiology of pain, pain mechanisms, and the relationship between pain and tissue damage. |
| Control group | No intervention | –Participants in the control group continued their regular sports training programs throughout the study period and did not receive pain neuroscience education or any additional educational or therapeutic intervention related to pain management. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- 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
Key exclusion criteria (5 listed)
- 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
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Pain neuroscience educationPain 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 | Other | Pain Neuroscience group |
Primary outcome
Visual analog scale
Time frame: 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)
Time frame: 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)
Time frame: 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
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 6 Feb 2026.
- BackgroundSullivan MJ, Bishop SR, Pivik J. Pain catastrophizing scale. Psychol Assess. 1995;7(4):524-532.
- Background: PubMed 22588748Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken). 2011 Nov;63 Suppl 11:S240-52. doi: 10.1002/acr.20543. No abstract available.
- Background: PubMed 23651882Catley MJ, O'Connell NE, Moseley GL. How good is the neurophysiology of pain questionnaire? A Rasch analysis of psychometric properties. J Pain. 2013 Aug;14(8):818-27. doi: 10.1016/j.jpain.2013.02.008. Epub 2013 May 4.
- Background: PubMed 38255102Sastre-Munar A, Romero-Franco N. Pain Education in the Wellness, Training Performance, and Pain Intensity of Youth Athletes: An Experimental Study. Healthcare (Basel). 2024 Jan 16;12(2):215. doi: 10.3390/healthcare12020215.
- Background: PubMed 40563828Sanchez-Robalino A, Sinchi-Sinchi H, Ramirez A. Effectiveness of Pain Neuroscience Education in Physical Therapy: A Systematic Review and Meta-Analysis. Brain Sci. 2025 Jun 18;15(6):658. doi: 10.3390/brainsci15060658.
- Background: PubMed 38075271Cuenca-Martinez F, Suso-Marti L, Calatayud J, Ferrer-Sargues FJ, Munoz-Alarcos V, Alba-Quesada P, Bivia-Roig G. Pain neuroscience education in patients with chronic musculoskeletal pain: an umbrella review. Front Neurosci. 2023 Nov 24;17:1272068. doi: 10.3389/fnins.2023.1272068. eCollection 2023.
- Background: PubMed 36767858Gajardo-Burgos R, Valdebenito-Tejos C, Galvez-Garcia G, Bascour-Sandoval C. Pain and Psychological Readiness to Return to Sport in Elite Volleyball Players: A Cross-Sectional Study. Int J Environ Res Public Health. 2023 Jan 30;20(3):2492. doi: 10.3390/ijerph20032492.
- Background: PubMed 36237643Alaiti RK, Reis FJJ. Pain in Athletes: Current Knowledge and Challenges. Int J Sports Phys Ther. 2022 Oct 1;17(6):981-983. doi: 10.26603/001c.37675. eCollection 2022. No abstract available.
- Background: PubMed 28579013Malfliet A, Leysen L, Pas R, Kuppens K, Nijs J, Van Wilgen P, Huysmans E, Goudman L, Ickmans K. Modern pain neuroscience in clinical practice: applied to post-cancer, paediatric and sports-related pain. Braz J Phys Ther. 2017 Jul-Aug;21(4):225-232. doi: 10.1016/j.bjpt.2017.05.009. Epub 2017 May 19.
- Derived from this study: PubMed 42002795Koc H, Dengiz A. Pain neuroscience education for the management of chronic pain in elite volleyball players with chronic shoulder pain: a randomized controlled trial. BMC Sports Sci Med Rehabil. 2026 Apr 20;18(1):257. doi: 10.1186/s13102-026-01698-6.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Aziz DENGİZ, Assist. Prof. principal investigator
Muş Alparslan University
Harun KOÇ, Assist. Prof. study director
Muş Alparslan University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Pain neuroscience education in people with Pain Management and Sport Injuries, run by Pamukkale University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 6 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Visual analog scale (time frame: From enrollment to the end of treatment at 6 weeks"). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07393347, which also lists 10 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 Feb 2026.