Effectiveness of pain neuroscience education among adults with chronic neck pain. Systematic review

Abstract

Background

Pain neuroscience education (PNE) is a therapeutic strategy that has proven its effectiveness among several chronic pain conditions, but its effectiveness in chronic neck pain (CNP) is still uncertain. This systematic review assesses the evidence of PNE effectiveness among adults with CNP.

Methods

A systematic review with no date limit was conducted until January 2024 through eight databases. Clinical trials assessing PNE effectiveness (in isolation or in combination with other therapies) among adults with CNP were selected. PNE was compared to other interventions or no intervention. Two independent authors extracted information and assessed the methodological quality of the included studies with Cochrane Collaboration Risk of Bias Tool 2. Results were reported through a narrative synthesis.

Results

Eleven interventions in seven randomised clinical trials (422 participants) were selected. PNE was evaluated with great variability of outcome instruments. PNE groups showed effectiveness (vs. control group) for the following: kinesiophobia (in 3 out of 4 studies with this outcome), fear and avoidance beliefs (2/2), catastrophizing (2/4), anxiety (1/1), pain neurophysiology knowledge (1/1), pain intensity (2/4), disability (2/3), self-efficacy (1/1) and perceived overall improvement (1/1).

Conclusions

PNE may have an effect on CNP compared with other therapies, especially regarding beliefs and attitudes.

Keywords:

• Systematic review
• pain neuroscience education
• neck pain
• chronic neck pain
• physical therapy

Acknowledgements

We would like to acknowledge the support from the European Union, NextGenerationEU, the Minister of Universities, and the Autonomous University of Barcelona (UAB).

Ethical approval

The paper presents a review of the literature and does not involve human participants or identifiable personal information.

Authors contributions

Ivan Palahí Calsina, Olga Borao, and Júlia Jubany: conceptualisation, data curation, formal analysis, investigation, methodology, validation, visualisation, writing–original draft, writing–review and editing. Luis Sordo: conceptualisation, methodology, writing–review and editing. Sonia Lorente: formal analysis, methodology, writing–review and editing. Albert Espelt: writing–review and editing.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Declaration of generative AI and AI-assisted technologies in the writing process

This publication did not include any generative AI or AI-assisted technologies in the writing process.

Additional information

Funding

The authors declare that no funding was involved in this study. SL is granted by the Margarita Salas fellowship, by the European Union, NextGenerationEU, in collaboration with the Minister of Universities and the Universitat Autònoma de Barcelona (UAB).