Pain Neuroscience education

Pain Neuroscience Education – Cart Before the Horse?

This review examines the impact of pain neuroscience education on patients with chronic musculoskeletal pain.

did we skip basic education?

Chronic Musculoskeletal Pain (CMP) affects 20% of adults worldwide and is a leading cause of disability. It reduces quality of life and can result in socioeconomic burdens. CMP is complex and multifactorial, with central sensitization mechanisms contributing to chronification and perception influenced by factors like hypervigilance, catastrophizing, kinesiophobia, anxiety, and depression. Healthcare professionals must incorporate a biopsychosocial approach to treat CMP effectively.1

Patient education is crucial in the treatment of Chronic Pain Management (CMP) in Europe. It involves counseling, teaching, and behavior modification to increase patients’ knowledge and promote positive pain-related beliefs. Pain neuroscience education (PNE) aims to provide patients with a thorough understanding of neurobiological processes involved in their pain experience, thereby changing negative beliefs and incorrect perceptions. Research suggests PNE can increase knowledge, produce cognitive changes, and positively affect pain intensity, disability, kinesiophobia, catastrophizing, and pain-mediating factors.

Pain Neuroscience Education (PNE) has been researched in the field of physical therapy, showing promise in combination with manual therapy or exercise. However, controversies exist, suggesting that PNE may only be effective for some patients and that individual differences in response to treatment may influence outcome variables. Additionally, the application of PNE remains a challenge due to individual differences in understanding and resources, despite the potential benefits of manual therapy.

These researchers looked to an umbrella review—a methodological approach that synthesizes the results of systematic reviews, addressing potential biases and overlaps in studies. This review aims to assess and evaluate previous systematic reviews on PNE for patients with CMP, elucidating controversies and determining its effectiveness in this population.

Skipping to the Discussion of the Paper – Interesting.

The umbrella review aimed to assess the effectiveness of Pain Management Interventions (PNE) in patients with Chronic Musculoskeletal Pain (CMP). The results showed that the addition of PNE-based interventions to exercise-based treatments leads to greater clinical improvements than the multimodal approach alone. The main strength of PNE is its interaction with other interventions to enhance its effectiveness. However, studies testing the effectiveness of PNE in isolation did not show statistically significant improvements overall in terms of pain intensity, disability levels, or psychosocial variables. The mechanisms that explain the functioning and benefits of PNE are not entirely clear. The current state of the art suggests that combining PNE with active and passive interventions, such as exercise-based interventions, manual neuro-orthopedic physical therapy, is necessary to improve its effectiveness. Future studies should address the limitations and weaknesses found in the present manuscript and determine whether PNE can improve the efficacy of exercise-based interventions, as well as in which patients it is effective and in what way it is best applied.

Professional Lxh Model Demonstrating LDH
Professional Lxh Model Demonstrating LDH

Dynamic Disc Designs

At ddd, we believe in tailoring a basic science education approach to each patient. Just as each model we create is unique, so are the patients in their search for pain solutions. We aid the healthcare professional deliver education at a basic level, in an artistic way to help deliver realistic anatomical education with a dynamic disc.