Archives of Physical Medicine and Rehabilitation
Volume 92, Issue 12 , Pages 2041-2056 , December 2011

The Effect of Neuroscience Education on Pain, Disability, Anxiety, and Stress in Chronic Musculoskeletal Pain

  • Adriaan Louw, PT, MAppSc

      Affiliations

    • International Spine Pain Institute and Neuro Orthopaedic Institute, Story City, IA
    • ,
  • Ina Diener, PT, PhD

      Affiliations

    • Department of Physiotherapy, Stellenbosch University, Stellenbosch, South Africa
    • ,
  • David S. Butler, PT, EdD

      Affiliations

    • Neuro Orthopaedic Institute and University of South Australia, Adelaide, South Australia
    • ,
  • Emilio J. Puentedura, PT, DPT

      Affiliations

    • International Spine Pain Institute and Neuro Orthopaedic Institute, Story City, IA
    • Department of Physical Therapy, University of Nevada Las Vegas, Las Vegas, NV
    • Corresponding Author InformationReprint requests to Emilio J. Puentedura, PT, DPT, Assistant Professor, University of Nevada Las Vegas, School of Allied Health Sciences, Dept of Physical Therapy, 4505 Maryland Pkwy, Box 453029, Las Vegas, NV 89154-3029

References 

  1. Bernard AM , Wright SW . Chronic pain in the ED . Am J Emerg Med . 2004;22:444–447
  2. Mortimer M , Ahlberg G . To seek or not to seek? (Care-seeking behaviour among people with low-back pain) . Scand J Public Health . 2003;31:194–203
  3. Louw A , Louw Q , Crous LCC . Preoperative education for lumbar surgery for radiculopathy . S Afr J Physiother . 2009;65:3–8
  4. Brox JI , Storheim K , Grotle M , Tveito TH , Indahl A , Eriksen HR . Systematic review of back schools, brief education, and fear-avoidance training for chronic low back pain . Spine J . 2008;8:948–958
  5. Liddle SD , Gracey JH , Baxter GD . Advice for the management of low back pain: a systematic review of randomised controlled trials . Man Ther . 2007;12:310–327
  6. Heymans MW , van Tulder MW , Esmail R , Bombardier C , Koes BW . Back schools for nonspecific low back pain: a systematic review within the framework of the Cochrane Collaboration Back Review Group . Spine . 2005;30:2153–2163
  7. Engers A , Jellema P , Wensing M , van der Windt DA , Grol R , van Tulder MW . Individual patient education for low back pain . Cochrane Database Syst Rev . 2008;(1): CD004057
  8. Udermann BE , Spratt KF , Donelson RG , Mayer J , Graves JE , Tillotson J . Can a patient educational book change behavior and reduce pain in chronic low back pain patients? . Spine J . 2004;4:425–435
  9. Cohen JE , Goel V , Frank JW , Bombardier C , Peloso P , Guillemin F . Group education interventions for people with low back pain (An overview of the literature) . Spine . 1994;19:1214–1222
  10. Gross AR , Aker PD , Goldsmith CH , Peloso P . Patient education for mechanical neck disorders . Cochrane Database Syst Rev . 2000;(2): CD000962
  11. Maier-Riehle B , Harter M . The effects of back schools–a meta-analysis . Int J Rehabil Res . 2001;24:199–206
  12. Butler D , Moseley G . Explain pain . Adelaide: Noigroup; 2003;
  13. Moseley GL . A pain neuromatrix approach to patients with chronic pain . Man Ther . 2003;8:130–140
  14. Moseley GL . Evidence for a direct relationship between cognitive and physical change during an education intervention in people with chronic low back pain . Eur J Pain . 2004;8:39–45
  15. Koes BW , van Tulder MW , van der Windt WM , Bouter LM . The efficacy of back schools: a review of randomized clinical trials . J Clin Epidemiol . 1994;47:851–862
  16. Waddell G . The back pain revolution . 2nd ed.. Edinburgh: Churchill Livingstone; 2004;
  17. Nachemson AL . Newest knowledge of low back pain (A critical look) . Clin Orthop . 1992;(279):8–20
  18. Poiraudeau S , Rannou F , Baron G , et al.  Fear-avoidance beliefs about back pain in patients with subacute low back pain . Pain . 2006;124:305–311
  19. Hirsch MS , Liebert RM . The physical and psychological experience of pain: the effects of labeling and cold pressor temperature on three pain measures in college women . Pain . 1998;77:41–48
  20. Burton AK , Waddell G , Tillotson KM , Summerton N . Information and advice to patients with back pain can have a positive effect (A randomized controlled trial of a novel educational booklet in primary care) . Spine . 1999;24:2484–2491
  21. Moseley GL . Joining forces—combining cognition-targeted motor control training with group or individual pain physiology education: a successful treatment for chronic low back pain . J Man Manip Therap . 2003;11:88–94
  22. Moseley GL . Widespread brain activity during an abdominal task markedly reduced after pain physiology education: fMRI evaluation of a single patient with chronic low back pain . Aust J Physiother . 2005;51:49–52
  23. Moseley GL , Hodges PW , Nicholas MK . A randomized controlled trial of intensive neurophysiology education in chronic low back pain . Clin J Pain . 2004;20:324–330
  24. Ryan CG , Gray HG , Newton M , Granat MH . Pain biology education and exercise classes compared to pain biology education alone for individuals with chronic low back pain: a pilot randomised controlled trial . Man Ther . 2010;15:382–387
  25. Meeus M , Nijs J , Van Oosterwijck J , Van Alsenoy V , Truijen S . Pain physiology education improves pain beliefs in patients with chronic fatigue syndrome compared with pacing and self-management education: a double-blind randomized controlled trial . Arch Phys Med Rehabil . 2010;91:1153–1159
  26. Moseley GL . Unravelling the barriers to reconceptualisation of the problem in chronic pain: the actual and perceived ability of patients and health professionals to understand the neurophysiology . J Pain . 2003;4:184–189
  27. Moseley L . Combined physiotherapy and education is efficacious for chronic low back pain . Aust J Physiother . 2002;48:297–302
  28. Law M , Stewart D , Letts L , Pollock N , Bosch J , Westmoreland M . Critical review form–quantitative studies. www.fhs.mcmaster.ca/rehab/ebp/pdf/qualreview.pdf 1998; Accessed November 17, 2011
  29. Petticrew M . Why certain systematic reviews reach uncertain conclusions . BMJ . 2003;326:756–758
  30. Law M , Stewart D , Pollock N , Letts L , Bosch J , Westmoreland M . Guidelines for critical review form–quantitative studies, 1998. www.fhs.mcmaster.ca/rehab/ebp/pdf/qualguidelines.pdf Accessed November 17, 2011
  31. Bialocerkowski A , Kurlowicz K , Vladusick S , Grimmer K . Effectiveness of primary conservative management for infants with obstetric brachial plexus palsy . Int J Evid Based Healthc . 2005;3:27–44
  32. Daly AE , Bialocerkowski AE . Does evidence support physiotherapy management of adult complex regional pain syndrome type one? (A systematic review) . Eur J Pain . 2009;13:339–353
  33. Altman DG , Schulz KF , Moher D , et al.  The revised CONSORT statement for reporting randomized trials: explanation and elaboration . Ann Intern Med . 2001;134:663–694
  34. Moher D , Schulz KF , Altman DG . The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomized trials . Ann Intern Med . 2001;134:657–662
  35. Ezzo J , Berman B , Hadhazy VA , Jadad AR , Lao L , Singh BB . Is acupuncture effective for the treatment of chronic pain? (A systematic review) . Pain . 2000;86:217–225
  36. Fernandez-de-Las-Penas C , Alonso-Blanco C , Cuadrado ML , Miangolarra JC , Barriga FJ , Pareja JA . Are manual therapies effective in reducing pain from tension-type headache? (A systematic review) . Clin J Pain . 2006;22:278–285
  37. Stone PW . Popping the (PICO) question in research and evidence-based practice . Appl Nurs Res . 2002;15:197–198
  38. Herbert RD . How to estimate treatment effects from reports of clinical trials (I: Continuous outcomes) . Aust J Physiother . 2000;46:229–235
  39. Farrar JT , Young JP , LaMoreaux L , Werth JL , Poole RM . Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale . Pain . 2001;94:149–158
  40. Ferreira ML , Ferreira PH , Latimer J , Herbert R , Maher CG . Does spinal manipulative therapy help people with chronic low back pain? . Aust J Physiother . 2002;48:277–284
  41. Van Oosterwijck J , Nijs J , Meeus M , et al.  Pain neurophysiology education improves cognitions, pain thresholds, and movement performance in people with chronic whiplash: a pilot study . J Rehabil Res Dev . 2011;48:43–58
  42. Cherkin DC , Deyo RA , Battie M , Street J , Barlow W . A comparison of physical therapy, chiropractic manipulation, and provision of an educational booklet for the treatment of patients with low back pain . N Engl J Med . 1998;339:1021–1029
  43. Klaber Moffett JA , Torgeson D , Bell-Syer S , Jackson DL , Llewellyn-Phillips H . Randomised controlled trial of exercise for low back pain: clinical outcomes, costs and preferences . BMJ . 1999;319:279–283
  44. Coppieters MW , Alshami AM , Babri AS , Souvlis T , Kippers V , Hodges PW . Strain and excursion of the sciatic, tibial, and plantar nerves during a modified straight leg raising test . J Orthop Res . 2006;24:1883–1889
  45. Puentedura EJ , Brooksby CL , Wallmann HW , Landers MR . Rehabilitation following lumbosacral percutaneous nucleoplasty: a case report . J Orthop Sports Phys Ther . 2009;40:214–224
  46. Leal M , Sterling M , Elliott JA . combined manual therapy and pain educational treatment approach of a patient with elevated psychosocial variables and persistent neck pain: A case report (14th Annual Meeting of the American Academy of Orthopaedic Manual Physical Therapists) . 2008; Seattle, WA.
  47. Weiner BK . Spine update: the biopsychosocial model and spine care . Spine . 2008;33:219–223
  48. Henrotin YE , Cedraschi C , Duplan B , Bazin T , Duquesnoy B . Information and low back pain management: a systematic review . Spine . 2006;31:E326–E334
  49. Houben RM , Ostelo RW , Vlaeyen JW , Wolters PM , Peters M , Stomp-van den Berg SG . Health care providers' orientations towards common low back pain predict perceived harmfulness of physical activities and recommendations regarding return to normal activity . Eur J Pain . 2005;9:173–183
  50. Spoto MM , Collins J . Physiotherapy diagnosis in clinical practice: a survey of orthopaedic certified specialists in the USA . Physiother Res Int . 2008;13:31–41
  51. Morr S , Shanti N , Carrer A , Kubeck J , Gerling MC . Quality of information concerning cervical disc herniation on the internet . Spine J . 2010;10:350–354
  52. Greene DL , Appel AJ , Reinert SE , Palumbo MA . Lumbar disc herniation: evaluation of information on the internet . Spine (Phila Pa 1976) . 2005;30:826–829
  53. Melzack R . Pain and the neuromatrix in the brain . J Dent Educ . 2001;65:1378–1382
  54. Dean E . Physical therapy in the 21st century (part II): evidence-based practice within the context of evidence-informed practice . Physiother Theory Pract . 2009;25:354–368
  55. Murphy BP , Greathouse D , Matsui I . Primary care physical therapy practice models . J Orthop Sports Phys Ther . 2005;35:699–707
  56. Childs JD , Whitman JM . Advancing physical therapy practice: the accountable practitioner . J Orthop Sports Phys Ther . 2005;35:624–627
  57. Busch AJ , Barber KA , Overend TJ , Peloso PM , Schachter CL . Exercise for treating fibromyalgia syndrome . Cochrane Database Syst Rev . 2007;(4): CD003786
  58. Nijs J , Van Houdenhove B . From acute musculoskeletal pain to chronic widespread pain and fibromyalgia: application of pain neurophysiology in manual therapy practice . Man Ther . 2009;14:3–12
  59. Meeus M , Nijs J , Meirleir KD . Chronic musculoskeletal pain in patients with the chronic fatigue syndrome: a systematic review . Eur J Pain . 2007;11:377–386
  60. Adam JA , Khaw FM , Thomson RG , Gregg PJ , Llewellyn-Thomas HA . Patient decision aids in joint replacement surgery: a literature review and an opinion survey of consultant orthopaedic surgeons . Ann R Coll Surg Engl . 2008;90:198–207
  61. McGregor AH , Burton AK , Sell P , Waddell G . The development of an evidence-based patient booklet for patients undergoing lumbar discectomy and un-instrumented decompression . Eur Spine J . 2007;16:339–346
  62. Coudeyre E, Demaille-Wlodyka S, Poizat S, Burton K, Hamonet MA, Revel M, et al. Could a simple educational intervention modify beliefs about whiplash? (A preliminary study among professionals working in a rehabilitation ward) . Ann Readapt Med Phys. 2007;50:552–557 545-51
  63. Carvalho H . Active teaching and learning for a deeper understanding of physiology . Adv Physiol Educ . 2009;33:132–133
  64. Crabtree JL , Royeen CB , Mu K . The effects of learning through discussion in a course in occupational therapy: a search for deep learning . J Allied Health . 2001;30:243–247
  65. Sandberg J , Barnard Y . Deep learning is difficult . Instr Sci . 1997;25:15–36
  66. Scholten I , Keeves JP , Lawson MJ . Validation of a free response test of deep learning about the normal swallowing process . Higher Education . 2002;44:233–255
  67. Wittmann-Price RA , Godshall M . Strategies to promote deep learning in clinical nursing courses . Nurse Educ . 2009;34:214–216
  68. Moseley GL , Brhyn L , Ilowiecki M , Solstad K , Hodges PW . The threat of predictable and unpredictable pain: differential effects on central nervous system processing? . Aust J Physiother . 2003;49:263–267
  69. Moseley GL , Nicholas MK , Hodges PW . Does anticipation of back pain predispose to back trouble? . Brain . 2004;127(Pt 10):2339–2347
  70. Cleland JA , Fritz JM , Childs JD . Psychometric properties of the Fear-Avoidance Beliefs Questionnaire and Tampa Scale of Kinesiophobia in patients with neck pain . Am J Phys Med Rehabil . 2008;87:109–117
  71. Thomas JS , France CR . Pain-related fear is associated with avoidance of spinal motion during recovery from low back pain . Spine . 2007;32:E460–E466
  72. Smeets RJ . A comparison of the relationship between depression, perceived disability, and physical performance in persons with chronic pain: a comment on Alschuler et al (2008) . Eur J Pain . 2009;13:109–110 author reply 111-2
  73. Smeets RJ . Do lumbar stabilising exercises reduce pain and disability in patients with recurrent low back pain? . Aust J Physiother . 2009;55:138
  74. Lotze M , Erb M , Flor H , Huelsman E . fMRI evaluation of somatotopic representation in human primary motor cortex . Neuroimage . 2000;11(5 Pt 1):473–481
  75. Peyron R , Laurent B , Garcia-Larrea L . Functional imaging of brain responses to pain (A review and meta-analysis (2000)) . Neurophysiol Clin . 2000;30:263–288
  76. Morley S , Eccleston C , Williams A . Systematic review and meta-analysis of randomized controlled trials of cognitive behaviour therapy and behaviour therapy for chronic pain in adults, excluding headache . Pain . 1999;80:1–13
  77. Garcia-Campayo J , Serrano-Blanco A , Rodero B , et al.  Effectiveness of the psychological and pharmacological treatment of catastrophization in patients with fibromyalgia: a randomized controlled trial . Trials . 2009;10:24
  78. Wallin MK , Raak RI . Quality of life in subgroups of individuals with whiplash-associated disorders . Eur J Pain . 2008;12:842–849
  79. Turk DC . Combining somatic and psychosocial treatment for chronic pain patients: perhaps 1 + 1 does = 3 . Clin J Pain . 2001;17:281–283
  80. Kerns RD , Wagner J , Rosenberg R , Haythornthwaite J , Caudill-Slosberg M . Identification of subgroups of persons with chronic pain based on profiles on the pain stages of pain questionnaire . Pain . 2005;116:302–310
  81. Meeus M , Nijs J . Central sensitization: a biopsychosocial explanation for chronic widespread pain in patients with fibromyalgia and chronic fatigue syndrome . Clin Rheumatol . 2007;26:465–473
  82. LaMontagne L , Hepworth JT , Salisbury MH , Cohen F . Effects of coping instruction in reducing young adolescents' pain after major spinal surgery . Orthop Nurs . 2003;22:398–403
  83. Walters M , Coad J . Preparation of children for spinal surgery: an exploratory study . Paediatr Nurs . 2006;18:27–29
  84. Barton S . Which clinical studies provide the best evidence? (The best RCT still trumps the best observational study) . BMJ . 2000;321:255–256
  85. Norris SL , Atkins D . Challenges in using nonrandomized studies in systematic reviews of treatment interventions . Ann Intern Med . 2005;142(12 Pt 2):1112–1119
  86. Fukuda K , Straus SE , Hickie I , Sharpe MC , Dobbins JG , Komaroff A . The chronic fatigue syndrome: a comprehensive approach to its definition and study (International Chronic Fatigue Syndrome Study Group) . Ann Intern Med . 1994;121:953–959
  87. Australian National Health and Medical Research Council . How to review the evidence: systematic identification and review of the scientific literature. http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/cp65.pdf?q=publications/synopses/_files/cp65.pdf 1999; Accessed, November 16, 2011

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

PII: S0003-9993(11)00670-8

doi: 10.1016/j.apmr.2011.07.198

Archives of Physical Medicine and Rehabilitation
Volume 92, Issue 12 , Pages 2041-2056 , December 2011

Article Tools

* Image Usage & Resolution