Kaohsiung Rukang Physiotherapy Clinic, Kaohsiung, Taiwan.
Department of Physical Medicine and Rehabilitation, Lo-Hsu Medical Foundation, Inc., Lotung Poh-Ai Hospital, Yilan, Taiwan.
Eur J Pain. 2024 Feb;28(2):231-243. doi: 10.1002/ejp.2182. Epub 2023 Sep 11.
Chronic neck pain (CNP) is a common musculoskeletal disorder. Pain neuroscience education (PNE) is a promising nonpharmacological intervention for CNP, however, its effectiveness remains unclear. This systematic review and meta-analysis aimed to evaluate the effectiveness of PNE in treating CNP.
Electronic databases from inception to February 2023 were searched for randomized controlled trials (RCTs) on the effects of PNE on CNP. The primary outcome was the change in pain intensity, and the secondary outcome was improvement in kinesiophobia, standardized using Hedges' g. Two authors independently scrutinized eligible articles, extracted data and assessed quality; a random-effects model was employed for data pooling.
In total, seven RCTs comprising 479 participants were included and demonstrated that PNE significantly reduced pain intensity (Hedges' g = -0.730, 95% CI = -1.340 to -0.119, p = 0.019, I = 89.288%). Subgroup analysis revealed that the adult group experienced significant pain reduction after PNE, whereas the adolescent group did not. PNE also reduced kinesiophobia which was evaluated in four of seven RCTs (Hedges' g = -0.444, 95% CI = -0.735 to -0.154, p = 0.003, I = 36.822%). The meta-regression analysis indicated that an increased intervention duration contributed to greater pain reduction. No adverse events were reported following PNE or the control treatment.
PNE effectively reduced pain intensity and kinesiophobia in patients with CNP. A longer PNE time leads to greater pain reduction and is more effective in adults than in adolescents. Further studies are required to examine the long-term effects on CNP management.
This is the first meta-analysis evaluating the effectiveness of treating chronic neck pain with pain neuroscience education. Pain neuroscience education is successful in reducing pain and decreasing kinesiophobia in the chronic neck pain population. Longer treatment time leads to greater pain reduction.
慢性颈痛（CNP）是一种常见的肌肉骨骼疾病。疼痛神经科学教育（PNE）是一种有前途的非药物干预 CNP 的方法，但其效果仍不清楚。本系统评价和荟萃分析旨在评估 PNE 治疗 CNP 的效果。
从开始到 2023 年 2 月，检索了关于 PNE 对 CNP 影响的随机对照试验（RCT）的电子数据库。主要结果是疼痛强度的变化，次要结果是运动恐惧症的改善，使用 Hedges'g 标准化。两位作者独立审查合格文章，提取数据并评估质量；使用随机效应模型进行数据合并。
共纳入 7 项 RCT，共 479 名参与者，结果表明 PNE 可显著降低疼痛强度（Hedges'g=-0.730，95%CI=-1.340 至-0.119，p=0.019，I²=89.288%）。亚组分析显示，PNE 后成年组疼痛明显减轻，而青少年组则没有。PNE 还降低了运动恐惧症，这在 7 项 RCT 中的 4 项中得到了评估（Hedges'g=-0.444，95%CI=-0.735 至-0.154，p=0.003，I²=36.822%）。元回归分析表明，干预时间的增加有助于更大程度地减轻疼痛。PNE 或对照治疗后未报告不良反应。
PNE 有效降低了 CNP 患者的疼痛强度和运动恐惧症。PNE 时间较长导致疼痛减轻更大，对成年人比青少年更有效。需要进一步研究以检查对 CNP 管理的长期影响。
这是第一项评估疼痛神经科学教育治疗慢性颈痛效果的荟萃分析。疼痛神经科学教育在减轻慢性颈痛人群的疼痛和减少运动恐惧症方面是成功的。治疗时间越长，疼痛减轻越大。
