Effectiveness of Pain Neuroscience Education in Reducing Pain, Disability, Kinesiophobia, and Catastrophizing in Patients with Chronic Low Back Pain: A Systematic Review and Meta-Analysis

Background and objectives: Pain neuroscience education (PNE) is a therapeutic strategy aimed at reconceptualizing pain in patients with chronic low back pain (CLBP). This systematic review with a meta-analysis (SRMA) aimed to assess the effectiveness of PNE in reducing pain, disability, kinesiophobi...

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Autores: Medina-Viedma, Luisa, Cortés-Pérez, Irene, Obrero-Gaitán, Esteban, Osuna-Pérez, María Catalina, Díaz-Fernández, Ángeles, López-Ruiz, María del Carmen, Zagalaz-Anula, Noelia
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Universidad de Jaén
Repositorio:RUJA. Repositorio Institucional de la Producción Científica de la Universidad de Jaén
OAI Identifier:oai:ruja.ujaen.es:10953/6521
Acceso en línea:https://doi.org/10.3390/medsci13040290
https://www.mdpi.com/2076-3271/13/4/290?utm_source=researchgate.net&utm_medium=article
https://hdl.handle.net/10953/6521
Access Level:acceso abierto
Palabra clave:Virtual reality
chronic pain
low back pain
physiotherapy
Health
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spelling Effectiveness of Pain Neuroscience Education in Reducing Pain, Disability, Kinesiophobia, and Catastrophizing in Patients with Chronic Low Back Pain: A Systematic Review and Meta-AnalysisMedina-Viedma, LuisaCortés-Pérez, IreneObrero-Gaitán, EstebanOsuna-Pérez, María CatalinaDíaz-Fernández, ÁngelesLópez-Ruiz, María del CarmenZagalaz-Anula, NoeliaVirtual realitychronic painlow back painphysiotherapyHealthBackground and objectives: Pain neuroscience education (PNE) is a therapeutic strategy aimed at reconceptualizing pain in patients with chronic low back pain (CLBP). This systematic review with a meta-analysis (SRMA) aimed to assess the effectiveness of PNE in reducing pain, disability, kinesiophobia, and catastrophizing in patients with CLBP at the end of the intervention, and at 1 and 3 months of follow-up. Materials and Methods: Following PRISMA guidelines, an SRMA was conducted after searching in PubMed Medline, Scopus, Web of Science, and PEDro databases from inception up to June 2025. The inclusion criteria agreed with the PICOS tool: population (patients with CLBP), intervention (PNE), comparator (physiotherapy or non-intervention), outcomes (pain, disability, kinesiophobia, and catastrophizing), and study design (randomized controlled trials (RCTs) and pilot RCTs). The PEDro scale was used to assess the methodological quality and risk of bias of the RCTs included. The pooled effect was assessed using the Cohen standardized mean difference (SMD) and its 95% confidence interval (95% CI) in a random-effects model. Results: Fifteen RCTs, including data from 810 patients (43.7 ± 5.2 years; 61% female) with CLBP were included. The mean methodological quality of the RCTs included was good (6.8 ± 1.1 on the PEDro scale). Selection, performance, and detection were the most important biases identified. Our meta-analysis demonstrated, at the end of the intervention, and at 1 and 3 months of follow-up, respectively, that PNE is effective in reducing pain intensity (SMD = −0.65, p = 0.005; SMD = −1.1, p < 0.001; SMD = −1; p < 0.001), disability (SMD = −0.6, p = 0.009; SMD = −0.78, p = 0.002; SMD = −0.84; p = 0.004), and kinesiophobia (SMD = −1.12, p < 0.001; SMD = −1.51, p < 0.001; SMD = −1.57; p = 0.001). In reducing catastrophizing, PNE was largely effective at the end of intervention (SMD = −0.9, p = 0.016) and at 1 month of follow-up (SMD = −1.36, p = 0.007). Conclusions: Our findings demonstrate that PNE is an effective therapeutic approach for the management of CLBP, reducing pain, disability, kinesiophobia, and catastrophizing in patients with CLBP.MDPI202520252025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://doi.org/10.3390/medsci13040290https://www.mdpi.com/2076-3271/13/4/290?utm_source=researchgate.net&utm_medium=articlehttps://hdl.handle.net/10953/6521reponame:RUJA. Repositorio Institucional de la Producción Científica de la Universidad de Jaéninstname:Universidad de JaénInglésMedical SciencesAttribution-NoDerivs 3.0 Spainhttp://creativecommons.org/licenses/by-nd/3.0/es/info:eu-repo/semantics/openAccessoai:ruja.ujaen.es:10953/65212026-06-24T12:41:07Z
dc.title.none.fl_str_mv Effectiveness of Pain Neuroscience Education in Reducing Pain, Disability, Kinesiophobia, and Catastrophizing in Patients with Chronic Low Back Pain: A Systematic Review and Meta-Analysis
title Effectiveness of Pain Neuroscience Education in Reducing Pain, Disability, Kinesiophobia, and Catastrophizing in Patients with Chronic Low Back Pain: A Systematic Review and Meta-Analysis
spellingShingle Effectiveness of Pain Neuroscience Education in Reducing Pain, Disability, Kinesiophobia, and Catastrophizing in Patients with Chronic Low Back Pain: A Systematic Review and Meta-Analysis
Medina-Viedma, Luisa
Virtual reality
chronic pain
low back pain
physiotherapy
Health
title_short Effectiveness of Pain Neuroscience Education in Reducing Pain, Disability, Kinesiophobia, and Catastrophizing in Patients with Chronic Low Back Pain: A Systematic Review and Meta-Analysis
title_full Effectiveness of Pain Neuroscience Education in Reducing Pain, Disability, Kinesiophobia, and Catastrophizing in Patients with Chronic Low Back Pain: A Systematic Review and Meta-Analysis
title_fullStr Effectiveness of Pain Neuroscience Education in Reducing Pain, Disability, Kinesiophobia, and Catastrophizing in Patients with Chronic Low Back Pain: A Systematic Review and Meta-Analysis
title_full_unstemmed Effectiveness of Pain Neuroscience Education in Reducing Pain, Disability, Kinesiophobia, and Catastrophizing in Patients with Chronic Low Back Pain: A Systematic Review and Meta-Analysis
title_sort Effectiveness of Pain Neuroscience Education in Reducing Pain, Disability, Kinesiophobia, and Catastrophizing in Patients with Chronic Low Back Pain: A Systematic Review and Meta-Analysis
dc.creator.none.fl_str_mv Medina-Viedma, Luisa
Cortés-Pérez, Irene
Obrero-Gaitán, Esteban
Osuna-Pérez, María Catalina
Díaz-Fernández, Ángeles
López-Ruiz, María del Carmen
Zagalaz-Anula, Noelia
author Medina-Viedma, Luisa
author_facet Medina-Viedma, Luisa
Cortés-Pérez, Irene
Obrero-Gaitán, Esteban
Osuna-Pérez, María Catalina
Díaz-Fernández, Ángeles
López-Ruiz, María del Carmen
Zagalaz-Anula, Noelia
author_role author
author2 Cortés-Pérez, Irene
Obrero-Gaitán, Esteban
Osuna-Pérez, María Catalina
Díaz-Fernández, Ángeles
López-Ruiz, María del Carmen
Zagalaz-Anula, Noelia
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Virtual reality
chronic pain
low back pain
physiotherapy
Health
topic Virtual reality
chronic pain
low back pain
physiotherapy
Health
description Background and objectives: Pain neuroscience education (PNE) is a therapeutic strategy aimed at reconceptualizing pain in patients with chronic low back pain (CLBP). This systematic review with a meta-analysis (SRMA) aimed to assess the effectiveness of PNE in reducing pain, disability, kinesiophobia, and catastrophizing in patients with CLBP at the end of the intervention, and at 1 and 3 months of follow-up. Materials and Methods: Following PRISMA guidelines, an SRMA was conducted after searching in PubMed Medline, Scopus, Web of Science, and PEDro databases from inception up to June 2025. The inclusion criteria agreed with the PICOS tool: population (patients with CLBP), intervention (PNE), comparator (physiotherapy or non-intervention), outcomes (pain, disability, kinesiophobia, and catastrophizing), and study design (randomized controlled trials (RCTs) and pilot RCTs). The PEDro scale was used to assess the methodological quality and risk of bias of the RCTs included. The pooled effect was assessed using the Cohen standardized mean difference (SMD) and its 95% confidence interval (95% CI) in a random-effects model. Results: Fifteen RCTs, including data from 810 patients (43.7 ± 5.2 years; 61% female) with CLBP were included. The mean methodological quality of the RCTs included was good (6.8 ± 1.1 on the PEDro scale). Selection, performance, and detection were the most important biases identified. Our meta-analysis demonstrated, at the end of the intervention, and at 1 and 3 months of follow-up, respectively, that PNE is effective in reducing pain intensity (SMD = −0.65, p = 0.005; SMD = −1.1, p < 0.001; SMD = −1; p < 0.001), disability (SMD = −0.6, p = 0.009; SMD = −0.78, p = 0.002; SMD = −0.84; p = 0.004), and kinesiophobia (SMD = −1.12, p < 0.001; SMD = −1.51, p < 0.001; SMD = −1.57; p = 0.001). In reducing catastrophizing, PNE was largely effective at the end of intervention (SMD = −0.9, p = 0.016) and at 1 month of follow-up (SMD = −1.36, p = 0.007). Conclusions: Our findings demonstrate that PNE is an effective therapeutic approach for the management of CLBP, reducing pain, disability, kinesiophobia, and catastrophizing in patients with CLBP.
publishDate 2025
dc.date.none.fl_str_mv 2025
2025
2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://doi.org/10.3390/medsci13040290
https://www.mdpi.com/2076-3271/13/4/290?utm_source=researchgate.net&utm_medium=article
https://hdl.handle.net/10953/6521
url https://doi.org/10.3390/medsci13040290
https://www.mdpi.com/2076-3271/13/4/290?utm_source=researchgate.net&utm_medium=article
https://hdl.handle.net/10953/6521
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Medical Sciences
dc.rights.none.fl_str_mv Attribution-NoDerivs 3.0 Spain
http://creativecommons.org/licenses/by-nd/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Attribution-NoDerivs 3.0 Spain
http://creativecommons.org/licenses/by-nd/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
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