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NEW YORK, NY, UNITED STATES, March 23, 2026 /EINPresswire.com/ — Excerpt from Article: Pain Neuroscience Education (PNE) is Relatively Ineffective
– Additional Article: Using Research for Better Practice
– Related Article: Meta-analysis Problems: Why do so many imply that nothing works?
PAIN SCIENCE HAS A PROBLEM
Pain science research currently has an interesting problem. It is amazing work, by incredible professionals, that has helped to inform theoretical frameworks on physical rehabilitation. However, the relatively strong correlations made between pain and psychosocial factors (demonstrated in some research studies), have resulted in a focus on addressing these psychosocial factors with cognitive interventions. The problem is these cognitive approaches do not have a large effect on the factors they are attempting to address, and worse, changes in cognitive factors seem to have little if any effect on objective outcome measures (e.g. pain-free range of motion, neck disability index scores, etc.). At the very least, these cognitive approaches are far less effective than manual therapy, specific exercise, and other effective modalities. Author’s note, it seems that a surge in the amount of research published on pain science was highjacked by a relatively ineffective application of that research (e.g. pain science education (PNE)). Worse still, some individuals have asserted that this surge in research and popularity of PNE programs is evidence of PNE being “new and better” while discrediting other more effective modalities. This type of strategy has won political campaigns, but it is not evidence-based practice.
THOUGHT EXPERIMENT ON “BEST POSSIBLE TREATMENT”
Imagine placing every possible physical rehabilitation technique in a pile on a table, regardless of professional titles or personal preferences. Which techniques would be selected from this pile for our patients? It can be assumed that most professionals would select the best possible techniques or the best possible combination of techniques. To keep it relatively simple and objective, define “best possible” in terms of two measures: reliability (the percentage of times it yields a positive outcome) and effect size (the magnitude of improvement). The number of techniques selected would be limited by the length of a session; that is, the number of techniques selected could comfortably be performed within the length of a normal session. Based on these standards, pain neuroscience education (PNE) would likely rarely if ever be chosen in an outpatient orthopedic physical rehabilitation and/or sports medicine clinic (e.g. issues including chronic low back pain, shoulder impingement syndrome, acute ACL ruptures, etc.). Based on the research below, PNE may be the ice and TENS of the next generation of therapists. Occasionally, these modalities are beneficial to improve a patient’s compliance or ability to initially endure an intervention plan, but they cannot be considered the basis of a therapeutic approach, should comprise an exceedingly small portion of therapy time, and billing for these modalities should be minimal.
Fact: The factors that correlate most with the experience of pain, are not as important as the magnitude of change that can be made for any correlated factor, and the effect that change has on patient outcomes…
CHECK OUT THE FULL ARTICLE (INCLUDING SYSTEMATIC REVIEW) BY FOLLOWING THE LINK
Brent Brookbush
Brookbush Institute
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