Chronic pain is the leading cause of disability worldwide affecting just under 28 million people in the UK. Chronic pain conditions require a biopsychosocial rather than a biomedical model of care. Biomedical management lacks evidence of effectiveness but also has the potential to exacerbate the condition by raising fears and anxiety about potential pathological abnormalities.

Thus, the pre-registration phase is an important point where an individual's understanding of, and beliefs about, pain and people with pain may be shaped for the future. The need for improved and better education of healthcare professionals to support best practice for low back pain with the aim of integrating professionals' management of low back pain and fostering innovation in practice is well recognised. Pain education research with pre-registration chiropractors is lacking.

Therefore, this study aims to:

To compare the effect of two pain education intervention, through a multi-site randomised control trial, on the following three questionnaire based outcome measures:

1. Knowledge (understanding) of chronic pain
2. Attitudes towards chronic pain patients
3. Pain management behaviours

In 2011 Briggs et al described pain education at undergraduate level for healthcare professionals as 'woefully inadequate'. Pain Neurophysiology Education (PNE) can improve undergraduates' pain understanding/management, however previous RCTs used single discipline groups and immediate follow-up. Investigation of the effectiveness of this education on students across the multi-professional team with medium-to-long-term follow-up will provide important new information on the generalisability of existing data and whether or not any changes in pain understanding/management are maintained over time.

This study aims to contribute to the development of neuromusculoskeletal chiropractic education by identifying whether or not this education, which aims to up skill healthcare professionals of the future, is effective and can change their behaviours in practice to enhance patient care in chronic pain management. PNE has been shown to be useful in patient care in conjunction with other treatment methods. If this intervention is successful in altering pain attitudes and knowledge in keeping with modern science then students may feel more confident and able to manage pain post qualification. The findings of this study will support or refute the addition of PNE into healthcare professional undergraduate programmes

Inclusion Criteria:

• Current Chiropractic students enrolled at either: Teesside University; The Welsh institute of Chiropractic - University of South Wales; The AECC University College; McTimoney College of Chiropractic; London Southbank University
• Willing to consent to attending two educational sessions followed by completing questionnaires

Exclusion Criteria:

• Chiropractic students not actively enrolled at either: Teesside University; The Welsh institute of Chiropractic - University of South Wales; The AECC University College; McTimoney College of Chiropractic; London Southbank University
• Participants will be excluded if they have previously received in depth education on red flags and or pain neurophysiology.
• Students not willing to consent to attending two educational sessions followed by the completion of questionnaires

Participant information is pseudonymised using student numbers only. As soon is data is generated data will be fully anonymised.

The outcome assessor will be blinded to group allocation.