title: The effect of neuroscience education on pain, disability, anxiety, and stress in chronic musculoskeletal pain.
abstract: OBJECTIVE
  To evaluate the evidence for the effectiveness of neuroscience education (NE) for pain, disability, anxiety, and stress in chronic musculoskeletal (MSK) pain.
  
  
  METHODS
  Systematic searches were conducted on Biomed Central, BMJ.com, CINAHL, the Cochrane Library, NLM Central Gateway, OVID, ProQuest (Digital Dissertations), PsycInfo, PubMed/Medline, ScienceDirect, and Web of Science. Secondary searching (PEARLing) was undertaken, whereby reference lists of the selected articles were reviewed for additional references not identified in the primary search.
  
  
  METHODS
  All experimental studies including randomized controlled trials (RCTs), nonrandomized clinical trials, and case series evaluating the effect of NE on pain, disability, anxiety, and stress for chronic MSK pain were considered for inclusion. Additional limitations: studies published in English, published within the last 10 years, and patients older than 18 years. No limitations were set on specific outcome measures of pain, disability, anxiety, and stress.
  
  
  METHODS
  Data were extracted using the participants, interventions, comparison, and outcomes (PICO) approach.
  
  
  RESULTS
  Methodological quality was assessed by 2 reviewers using the Critical Review Form-Quantitative Studies. This review includes 8 studies comprising 6 high-quality RCTs, 1 pseudo-RCT, and 1 comparative study involving 401 subjects. Most articles were of good quality, with no studies rated as poor or fair. Heterogeneity across the studies with respect to participants, interventions evaluated, and outcome measures used prevented meta-analyses. Narrative synthesis of results, based on effect size, established compelling evidence that NE may be effective in reducing pain ratings, increasing function, addressing catastrophization, and improving movement in chronic MSK pain.
  
  
  CONCLUSIONS
  For chronic MSK pain disorders, there is compelling evidence that an educational strategy addressing neurophysiology and neurobiology of pain can have a positive effect on pain, disability, catastrophization, and physical performance.
authors: International Spine Pain Institute, Story City, IA, USA.
authors: Adriaan
authors: A
authors: Louw
authors: Ina
authors: I
authors: Diener
authors: David S
authors: DS
authors: Butler
authors: Emilio J
authors: EJ
authors: Puentedura
mesh_terms: D000223:Adaptation, Psychological; D001007:Anxiety; D059350:Chronic Pain / Q000517:prevention & control / Q000523:psychology / Q000534:rehabilitation*; D006233:Persons with Disabilities / Q000534:rehabilitation; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic; D016032:Randomized Controlled Trials as Topic; D013315:Stress, Psychological; D011795:Surveys and Questionnaires