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

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.