Pain neuroscience education combined with therapeutic exercises provides added benefit in the treatment of chronic neck pain

Review written by Dr Jarod Hall info

Key Points

  1. This study demonstrated that pain and disability, fear-avoidance beliefs, and pain catastrophizing were reduced, and that pain self-efficacy increased, from using therapeutic exercises alone and combined with pain neuroscience education in patients with chronic neck pain.
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Chronic neck pain (CNP) is a prevalent problem, with an annual occurrence of nonspecific neck pain that is between 30-50% (1,2). It has previously been demonstrated that subjects with CNP have lower neck strength than people without CNP, and there appears to be an association between CNP and reduced endurance and strength in the neck muscles (3,4). Additionally, patients with CNP also tend to have unsuitable pain cognitions, such as fear of movement, pain catastrophizing, and hypervigilance. Previous studies have shown that these cognitive factors are related to pain intensity and disability in patients with CNP (5,6).

The objective of this study was to determine whether adding pain neuroscience education (PNE) to therapeutic exercises improved pain-disability index, pain catastrophizing, fear-avoidance beliefs, and pain self-efficacy in subjects with chronic nonspecific neck pain.

Chronic neck pain is a prevalent problem, with an annual occurrence of nonspecific neck pain between 30-50%.
Clinicians should consider the addition of pain neuroscience education to an exercise-based approach for chronic neck pain.


This study was a three-arm randomized control trial, with 2 intervention groups and a control group. A total of 72 patients were recruited from 2 rehabilitation and physiotherapy centers.

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