Pain Neuroscience Education: Teaching People About Pain.

Chronic pain is an ever-increasing global challenge, and few strategies have been shown to significantly alter this trajectory, and a pure pharmaceutical approach, especially opioids, is not the answer. To truly impact a person with chronic pain's life, current best-evidence supports changing their cognitions (how they think about their pain), moving more, and calming the peripheral and central nervous system, including non-pharmacological strategies. All healthcare providers, however, must use a unified strategy regardless of their professional designation, skillset, and clinical setting.

Pain neuroscience education improves post-traumatic stress disorder, disability, and pain self-efficacy in veterans and service members with chronic low back pain: Preliminary results from a randomized controlled trial with 12-month follow-up.

Post-traumatic stress disorder (PTSD) and chronic low back pain (CLBP) are frequently co-morbid. Some research suggests that PTSD and CLBP may share common neurobiological mechanisms related to stress. Traditional biomedical education may be ineffective for PTSD and CLBP, especially when co-morbid.

Pain Neuroscience Education for Acute Pain.

Unlabelled: In musculoskeletal and sports medicine, pain has traditionally been linked to tissue injury, often assuming a linear correlation between tissue damage and pain intensity. However, modern pain science has illuminated the complexity of the human pain experience, incorporating psychosocial elements, nervous system sensitization, immune responses, and structural changes in the brain as factors. This contemporary understanding of pain has proven highly beneficial for both clinicians treating individuals in pain and those experiencing pain.

The correlation of trust as part of the therapeutic alliance in physical therapy and their relation to outcomes for patients with chronic low back pain.

Background: Previous qualitative research has listed trust as a component of the therapeutic alliance in physical therapy.

Objective: Quantitatively correlate trust and therapeutic alliance in physical therapy care for patients with chronic low back pain. The secondary aim was to investigate the relation of trust and therapeutic alliance with outcomes over the course of treatment.

Nociceptive, neuropathic, or nociplastic low back pain? The low back pain phenotyping (BACPAP) consortium's international and multidisciplinary consensus recommendations.

The potential to classify low back pain as being characterised by dominant nociceptive, neuropathic, or nociplastic mechanisms is a clinically relevant issue. Preliminary evidence suggests that these low back pain phenotypes might respond differently to treatments; however, more research must be done before making specific recommendations. Accordingly, the low back pain phenotyping (BACPAP) consortium was established as a group of 36 clinicians and researchers from 13 countries (five continents) and 29 institutions, to apply a modified Nominal Group Technique methodology to develop international and multidisciplinary consensus recommendations to provide guidance for identifying the dominant pain phenotype in patients with low back pain, and potentially adapt pain management strategies.

Effect of perioperative pain neuroscience education in people undergoing surgery for lumbar radiculopathy: a multicentre randomised controlled trial.

Background: Perioperative education should be improved to decrease unfavourable outcomes after lumbar surgery. This trial aimed to compare effectiveness in terms of pain, quality of life, pain cognition, surgical experience, healthcare use, work resumption, and cost-effectiveness of perioperative pain neuroscience education (PPNE) vs traditional biomedical education (perioperative biomedical education [PBE]) in people undergoing surgery for lumbar radiculopathy.

Methods: In this multicentre RCT (ClinicalTrials.

Pain Neuroscience Education in Elementary and Middle Schools.

Purpose: The purpose of this study was to deliver pain neuroscience education (PNE) to participants in grades 3 to 8 to determine whether participants in these grades had positive shifts in pain knowledge and beliefs.

Methods: Three hundred twenty participants, grades 3 to 8, received a 1-time, 30-minute PNE lecture. The Neurophysiology of Pain Questionnaire and the Health Care Provider's Pain and Impairment Relationship Scale were administered before and after the PNE lecture.

Is there any benefit of adding a central nervous system-focused intervention to a manual therapy and home stretching program for people with frozen shoulder? A randomized controlled trial.

Background: Frozen shoulder (FS) is a highly disabling pathology of poorly understood etiology, which is characterized by the presence of intense pain and progressive loss of range of motion. The aim of this study was to evaluate the effect of adding a central nervous system (CNS)-focused approach to a manual therapy and home stretching program in people with FS.

Methods: A total of 34 patients with a diagnosis of primary FS were randomly allocated to receive a 12-week manual therapy and home stretching program or manual therapy and home stretching program plus a CNS-focused approach including graded motor imagery and sensory discrimination training.

Cross-sectional analysis of generational differences in pain attitudes and beliefs of patients receiving physical therapy care in outpatient clinics.

Background: Musculoskeletal pain is a common reason to seek outpatient physical therapy care. Generational differences regarding attitudes and beliefs have been found in many areas, but it has not been explored regarding pain.

Objectives: This study aimed to examine generational differences in attitudes and beliefs regarding pain and the potential differences between beneficial and non-beneficial treatment options in patients receiving care in outpatient physical therapy clinics.

The relationship between trust and outcomes during physical therapy care for chronic low back pain.

Introduction: Enhancing the therapeutic alliance has been associated with improved outcomes for patients with chronic low back pain (CLBP). Qualitatively trust has been described to be part of the therapeutic alliance, but it has not been measured quantitatively within the physical therapy literature.

Objective: Examine the relationship between trust and outcomes during physical therapy for CLBP.

Virtual McKenzie extension exercises for low back and leg pain: a prospective pilot exploratory case series.

Introduction: Current evidence supports the inclusion of directional preference exercises for a subgroup of patients with low back (LBP) and leg pain. Recent pain neuroscience strategies have suggested that cortical restructuring associated with movement activating the body map representation in the brain might account for the observed improvement with the directional preference approach.

Objectives: To explore whether or not a motor imagery directional preference approach would result in any changes in patients with LBP and leg pain.

The clinical impact of pain neuroscience continuing education on physical therapy outcomes for patients with low back and neck pain.

Objectives: Research suggests that attendance by physical therapists at continuing education (CE) targeting the management of low back pain (LBP) and neck pain does not result in positive impacts on clinical outcomes. The aim of this study was to determine if therapists attending a self-paced 3-hour online Pain Neuroscience Education (PNE) program was associated with any observed changes to patient outcomes and also clinical practice.

Methods: Participants were 25 different physical therapists who treated 3,705 patients with low back pain (LBP) or neck pain before and after they had completed an online PNE CE course.

A Central Nervous System Focused Treatment Program for People with Frozen Shoulder: A Feasibility Study.

Background: Frozen shoulder (FS) is a highly disabling pathology of poorly understood etiology, which is characterized by the presence of intense pain and progressive loss of range of motion (ROM). The aim of this study is to evaluate the feasibility and clinical impact of a CNS-focused treatment program for people with FS. Methods: 10 subjects with primary FS received a 10-week CNS-focused intervention including sensory discrimination training and graded motor imagery techniques delivered as clinic sessions (60 min) and home therapy (30 min five times per week).

A Case-Series of Dry Needling as an Immediate Sensory Integration Intervention.

Background: Chronic low back pain (CLBP) has been associated with altered cortical mapping in the primary somatosensory cortex. Various sensory discrimination treatments have been explored to positively influence CLBP by targeting cortical maps.

Objectives: To determine if dry needling (DN) applied to patients with CLBP would yield changes in two-point discrimination (TPD) and left-right judgment (LRJ) tasks for the low back.

Effectiveness of training physical therapists in pain neuroscience education for patients with chronic spine pain: a cluster-randomized trial.

Chronic spinal pain poses complex challenges for health care around the world and is in need of effective interventions. Pain neuroscience education (PNE) is a promising intervention hypothesized to improve pain and disability by changing individuals' beliefs, perceptions, and expectations about pain. Pain neuroscience education has shown promise in small, controlled trials when implemented in tightly controlled situations.

"A journey to learn about pain": the development and validation of a comic book about pain neuroscience education for children.

Background: Pain education resources for children using appropriate language and illustrations remain scarce.

Objectives: We aimed to summarize the development process and testing for face and content validity of a structured comic book about pain education for children.

Methods: A first draft of a comic book was developed (Portuguese and English) based on pain education concepts.

Revisiting the Provision of Pain Neuroscience Education: An Adjunct Intervention for Patients but a Primary Focus of Clinician Education.

Society is mired in a serious health care crisis regarding pain and opioid abuse. Pain neuroscience education (PNE) has gained support in the last 20 years as an intervention to help people manage chronic pain. In this Viewpoint, we argue that exercise and movement must be the primary intervention for chronic pain conditions, and that PNE or other adjunctive therapies should only be used if they can foster increased exercise and movement participation.

Preoperative pain neuroscience education for shoulder surgery: A case series.

Background: Central sensitisation, in addition to high levels of fear-avoidance and pain catastrophisation may exist in a subgroup of patients with shoulder pain. Pain neuroscience education (PNE) has been shown to positively influence sensitivity of the nervous system, as well as reduce fear and catastrophisation prior to lumbar and total knee surgery. To date, no study has examined the application of PNE prior to shoulder surgery.

Behavior Change Following Pain Neuroscience Education in Middle Schools: A Public Health Trial.

Chronic pain and the opioid epidemic need early, upstream interventions to aim at meaningful downstream behavioral changes. A recent pain neuroscience education (PNE) program was developed and tested for middle-school students to increase pain knowledge and promote healthier beliefs regarding pain. In this study, 668 seventh-grade middle-school students either received a PNE lecture ( = 220); usual curriculum school pain education (UC) ( = 198) or PNE followed by two booster (PNEBoost) sessions ( = 250).

Physician-Delivered Pain Neuroscience Education for Opioid Tapering: A Case Report.

We describe the case of a 75-year-old female with chronic low back pain (CLBP), on opioids for more than 15 years. She presented with an acute episode of nausea, vomiting, abdominal pain, and shortness of breath. After a complete work-up, it was concluded that her presenting symptoms were likely due to her high levels of CLBP and high dose opioids.

Evaluation is treatment for low back pain.

: To investigate the effect of the examination process (history taking and physical examination) on pain and function. : An observational cohort trial of patients presenting to outpatient physical therapy clinics for the first time with low back pain (n = 34, 57.7 ± 18.

Integrating Motivational Interviewing in Pain Neuroscience Education for People With Chronic Pain: A Practical Guide for Clinicians.

Pain neuroscience education (PNE) and motivational interviewing (MI) have been widely implemented and tested in the field of chronic pain management, and both strategies have been shown to be effective in the short term (small effect sizes) for the management of chronic pain. PNE uses contemporary pain science to educate patients about the biopsychosocial nature of the chronicity of their pain experience. The goal of PNE is to optimize patients' pain beliefs/perceptions to facilitate the acquisition of adaptive pain-coping strategies.