Effectiveness of education based on neuroscience in the treatment of musculoskeletal chronic pain
*Correspondencia: Dr. Luis Espejo Antúnez. UNIVERSIDAD DE EXTREMADURA, 06071 Badajoz, Espana
E-mail: luisea@unex.es
Introduction. Chronic pain is one of the most frequent health, economic and social problems. Given this, numerous approaches have been described, one of which is pain neuroscience education.
Aim. To examine the effectiveness of pain neuroscience education in the treatment of musculoskeletal disorders with
chronic pain and to explore the impact of specific aspects of the technique on its effectiveness.
Material and methods. Relevant studies published between 2000 and 2015 were identified by searching PubMed, Scopus and Web of Science. Studies identified by electronic searches were screened against a set of pre-defined inclusion criteria. PEDro and SIGN scales were used to evaluate the methodological quality of the included studies.
Results. Ten studies were included in this systematic review. The main outcomes that were measured were pain, disability, neurophysiology pain test, attitudes and beliefs, fear-avoidance beliefs, self-care, kinesiophobia, quality of life and algometry. The results suggest that pain neuroscience education is effective in the short term and medium/long term for pain relief, either alone or combined with multimodal treatment. It was also effective in normalizing cognitions about pain, fearavoidance beliefs, and self-care.
Conclusion. Despite some evidence for a positive effect in the short and medium/long term, the heterogeneity in the
technical aspects used does not allow the obtaining of conclusive results.
Objetivo Determinar la efectividad de este abordaje y conocer el impacto de aspectos específicos referentes a su aplicación.
Materiales y métodos Se incluyeron estudios relevantes que cumplieran los criterios seleccionados, identificados en las bases de datos PubMed, Scopus y Web of Science, y publicados desde el año 2000 hasta 2015. La calidad metodológica y el grado de recomendación se evaluaron mediante las escalas PEDro y SIGN.
Resultados Se incluyeron 10 estudios en la revisión sistemática. Las variables medidas fueron dolor, discapacidad, conocimiento sobre la neurofisiología del dolor, creencias y cogniciones, miedo-evitación, cinesiofobia, calidad de vida y algometría. Los resultados sugieren que la educación basada en neurociencia del dolor resulta eficaz a corto plazo y medio/largo plazo para aliviar el dolor, ya sea aplicada sola o combinada con tratamiento multimodal. También resultó eficaz en la normalización de cogniciones sobre el dolor, las creencias de miedo-evitación y el autocuidado.
Conclusión A pesar de la eficacia a corto y medio/largo plazo, la heterogeneidad en los aspectos técnicos empleados no permite la obtención de resultados concluyentes.
