A meta-analysis of therapeutic pain neuroscience education, using dosage and treatment format as moderator variables

Review written by Dr Sandy Hilton info

Key Points

  1. Therapeutic pain neuroscience education (TPNE) is widely used in an attempt to reconceptualize pain in order to decrease pain and suffering.
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Therapeutic pain neuroscience education (TPNE) has evolved from an educational framework for research on chronic regional pain syndrome (CRPS), to a readable explanation in the Explain Pain phenomenon of Butler and Moseley (1), to a more commercialized product with certification courses and inclusion in multiple continuing education courses. This enthusiasm and clinical application comes from a desire to help the continued problem of chronic pain.

Chronic low back pain alone continues to be a global contributor to disability, and despite decades of study it remains poorly treated. The authors of this study acknowledged the challenge of pain and the popularity of TPNE for reconceptualizing the phenomena of pain in search of improved therapeutic outcomes. They sought to identify the overall effectiveness of TPNE on four common outcome measures, and to identify the dose effect of TPNE on those measures.

Chronic low back pain continues to be a global contributor to disability.
What is popular or trendy may not play out as well in the clinic as we initially hoped.


A systematic review of the literature post 2000 was conducted using normal methods and with clear criteria. The four main pain outcome measures for study were chosen based on their occurrence in the included literature, and included: fear of movement,

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