Author: Javier Martinez-Calderon1,2, Emma Kwan-Yee Ho3,4, Paulo Henrique Ferreira3, Cristina Garcia-Muñoz2,5, Olga Villar-Alises1,2, Javier Matias-Soto2,6
Affiliation:
1 Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, C/ Avenzoar, 6, 41009Sevilla, Spain.
2 Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group.
3 Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
4 Sydney Musculoskeletal Health, The Kolling Institute, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
5 Departamento de Enfermería y Fisioterapia, Facultad de Enfermería y Fisioterapia, Universidad de Cádiz, Avda. Ana de Viya 52, 11009Cádiz, Spain.
6 Universidad de Malaga, Faculty of Health Sciences, Department of Physical Therapy, Malaga, Spain.
Conference/Journal: J Orthop Sports Phys Ther
Date published: 2023 May 10
Other:
Special Notes: doi: 10.2519/jospt.2023.11833. , Word Count: 248
OBJECTIVE: To summarize the evidence of the effects of pain neuroscience education delivered alone or combined with other interventions for chronic pain. DESIGN: An overview of systematic reviews with meta-analysis. LITERATURE SEARCH: CINAHL (via EBSCOhost), Embase, PsycINFO (via ProQuest), PubMed, and the Cochrane Library were searched from inception until November 14th, 2022. STUDY SELECTION CRITERIA: Systematic reviews (SRs) with meta-analyses including randomized clinical trials. The outcomes were pain and psychological symptoms. DATA SYNTHESIS: AMSTAR 2 assessed the methodological quality of SRs. The primary study overlap was evaluated by calculating the corrected covered area (CCA). RESULTS: We included eight SRs including 30 meta-analyses of interest that comprised 28 distinct clinical trials. In some meta-analyses, pain neuroscience education delivered alone or combined with other interventions was more effective than control interventions for reducing pain intensity, pain catastrophizing, kinesiophobia, anxiety symptoms, and depression symptoms at some time points. However, other meta-analyses found a lack of effects of pain neuroscience education, and there were inconsistencies between meta-analyses covering the same outcome. The methodological quality of all SRs was critically low. The overlap, including all SRs, was high (CCA= 13%), and very high for SRs covering trials on chronic low back pain (CCA= 40%), chronic spine pain (CCA= 27%), and fibromyalgia (CCA= 25%). CONCLUSION: It is impossible to make clear clinical recommendations for delivering pain neuroscience education based on current meta-analyses. Action is needed to increase and improve the quality of SRs in the field of pain neuroscience education.
Keywords: chronic pain; education; meta-analysis; neurophysiology; neuroscience; systematic review.
PMID: 37161889 DOI: 10.2519/jospt.2023.11833
