Highlights
- •Pain neuroscience education can facilitate patients’ ability to cope with their condition.
- •Pain neuroscience education does not produce clinically significant decreases in pain.
- •Pain neuroscience education does not produce clinically significant decreases in disability.
- •Pain neuroscience education does produce clinically significant decreases in kinesiophobia.
- •Pain neuroscience education does produce clinically significant decreases in catastrophizing.
Abstract
Chronic musculoskeletal pain (CMP) is an urgent global public health concern. Pain
neuroscience education (PNE) is an intervention used in the management of CMP aiming
to reconceptualize an individual's understanding of their pain as less threatening.
This mixed-methods review undertook a segregated synthesis of quantitative and qualitative
studies to investigate the clinical effectiveness, and patients’ experience of, PNE
for people with CMP. Electronic databases were searched for studies published between
January 1, 2002, and June 14, 2018. Twelve randomized, controlled trials (n = 755
participants) that reported pain, disability, and psychosocial outcomes and 4 qualitative
studies (n = 50 participants) that explored patients experience of PNE were included.
The meta-analyzed pooled treatment effects for PNE versus control had low clinical
relevance in the short term for pain (−5.91/100; 95% confidence interval [CI], −13.75
to 1.93) and disability (−4.09/100; 95% CI, −7.72 to −.45) and in the medium term
for pain (−6.27/100; 95% CI, −18.97 to 6.44) and disability (−8.14/100; 95% CI, −15.60
to −.68). The treatment effect of PNE for kinesiophobia was clinically relevant in
the short term (–13.55/100; 95% CI, –25.89 to –1.21) and for pain catastrophizing
in the medium term (–5.26/52; 95% CI, –10.59 to .08). A metasynthesis of 23 qualitative
findings resulted in the identification of 2 synthesized findings that identified
several key components important for enhancing the patient experience of PNE, such
as allowing the patient to tell their own story. These components can enhance pain
reconceptualization, which seems to be an important process to facilitate patients’
ability to cope with their condition. The protocol was published on PROSPERO (CRD42017068436).
Perspective: We outline the effectiveness of PNE for the management of pain, disability,
and psychosocial outcomes in adults with CMP. Key components that can enhance the
patient experience of PNE, such as allowing the patient to tell their own story, are
also presented. These components may enhance pain reconceptualization.
Key words
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Article info
Publication history
Published online: March 01, 2019
Footnotes
Funded by Teesside University.
Supplementary data accompanying this article are available online at www.jpain.org and www.sciencedirect.com.
The authors have no conflict of interest to declare.
Identification
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© 2019 by the American Pain Society
