Effect of Pain Neuroscience Education on Pain, Sleep, and Psychosocial Factors in Chronic Musculoskeletal Pain Conditions: A Systematic Review and Meta-Analysis.

OBJECTIVE

This systematic review and meta-analysis examined the efficacy of pain neuroscience education (PNE) on pain, sleep parameters, and psychosocial factors in chronic musculoskeletal pain conditions in adults and adolescents.

METHODS

The review was conducted in accordance with the PRISMA guidelines. A systematic search was performed using the databases Medline (PubMed), Scopus, PEDro, and Web of Science. The qualitative assessment was done by using the Physiotherapy Evidence Database (PEDro) scale and the Cochrane Risk of Bias (ROB 2.0) tool. The quantitative analysis was performed using RevMan 5.4.1 using a random-effects model, an standarized mean diffeerence (SMD) with 95% confidence intervals (CIs), and the certainty of evidence was evaluated using GRADEpro/GDT.

RESULTS

Twelve randomized-controlled trials (n=1485) met the inclusion criteria. The meta-analysis showed a statistically significant effect in favor of PNE on reducing pain intensity (SMD: -0.27 [95% CI: -0.5 to 0.00; I2 =67%]) and total sleep time with a small to medium effect size (SMD: 0.42 [95% CI: 0.12-0.71; I2 =0%]). However, no statistically significant differences were observed for other sleep parameters and psychosocial outcomes, despite some outcomes indicating a moderate clinical effect.

DISCUSSION: The findings suggest that PNE alone can reduce pain intensity, but greater improvements in sleep and psychosocial outcomes are seen when it is combined with interventions such as cognitive-behavioral therapy (CBT) and therapeutic exercises. These results highlight the potential role of PNE within a multimodal approach to pain management, while also underscoring the need for further research on its impact on sleep parameters in a specific population.