Abstract
Louw A, Diener I, Butler DS, Puentedura EJ. The effect of neuroscience education on
pain, disability, anxiety, and stress in chronic musculoskeletal pain.
Objective
To evaluate the evidence for the effectiveness of neuroscience education (NE) for
pain, disability, anxiety, and stress in chronic musculoskeletal (MSK) pain.
Data Sources
Systematic searches were conducted on Biomed Central, BMJ.com, CINAHL, the Cochrane Library, NLM Central Gateway, OVID, ProQuest (Digital Dissertations), PsycInfo, PubMed/Medline, ScienceDirect, and Web of Science. Secondary searching
(PEARLing) was undertaken, whereby reference lists of the selected articles were reviewed
for additional references not identified in the primary search.
Study Selection
All experimental studies including randomized controlled trials (RCTs), nonrandomized
clinical trials, and case series evaluating the effect of NE on pain, disability,
anxiety, and stress for chronic MSK pain were considered for inclusion. Additional
limitations: studies published in English, published within the last 10 years, and
patients older than 18 years. No limitations were set on specific outcome measures
of pain, disability, anxiety, and stress.
Data Extraction
Data were extracted using the participants, interventions, comparison, and outcomes
(PICO) approach.
Data Synthesis
Methodological quality was assessed by 2 reviewers using the Critical Review Form–Quantitative
Studies. This review includes 8 studies comprising 6 high-quality RCTs, 1 pseudo-RCT,
and 1 comparative study involving 401 subjects. Most articles were of good quality,
with no studies rated as poor or fair. Heterogeneity across the studies with respect
to participants, interventions evaluated, and outcome measures used prevented meta-analyses.
Narrative synthesis of results, based on effect size, established compelling evidence
that NE may be effective in reducing pain ratings, increasing function, addressing
catastrophization, and improving movement in chronic MSK pain.
Conclusions
For chronic MSK pain disorders, there is compelling evidence that an educational strategy
addressing neurophysiology and neurobiology of pain can have a positive effect on
pain, disability, catastrophization, and physical performance.
Key Words
List of Abbreviations:
BPPT (brachial plexus provocation test), CFS (chronic fatigue syndrome), CLBP (chronic low back pain), CONSORT (Consolidated Standards of Reporting Trials), LBP (low back pain), MSK (musculoskeletal), NE (neuroscience education), NPRS (numeric pain rating scale), PCI (Pain Coping Inventory), PCS (Pain Catastrophization Scale), PICO (participants, interventions, comparison, outcomes), PPT (pressure pain threshold), PSEQ (Pain Self-Efficacy Questionnaire), RCT (randomized controlled trial), RMDQ (Roland Morris Disability Questionnaire), SLR (straight leg raise), SOPA(R) (Survey of Pain Attitudes (Revised)), TSK (Tampa Scale of Kinesiophobia), VAS (visual analog scale), WAD (whiplash-associated disorders)To read this article in full you will need to make a payment
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Footnotes
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.
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© 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
