Pain neuroscience education as an intervention to improve quality of life in patients with chronic low back pain : A scoping review of randomised controlled trials

Schmerz. 2026 Mar 12. doi: 10.1007/s00482-026-00929-6. Online ahead of print.

ABSTRACT

BACKGROUND: Educational strategies that improve understanding of pain can influence the behaviour of patients with chronic low back pain. One such strategy is pain neuroscience education (PNE), which is increasingly being used in chronic low back pain rehabilitation. However, little is known about its influence on psychosocial factors. Thus far, PNE has primarily been considered in terms of pain reduction and the alleviation of disability in the treatment of patients with chronic low back pain.

AIM: The aim of this scoping review was to summarise the findings of randomised controlled trials on the quality-of-life outcomes of PNE interventions for this population.

METHODS: A systematic literature search was carried out in the Medline (PubMed), PEDro and Cochrane Library databases between 1 May and 15 May 2024, with an update on 3 June 2025. Based on the defined inclusion and exclusion criteria, three randomised controlled trials (RCTs) were selected for analysis of the quality-of-life outcome parameter. The revised version of the Cochrane tool for assessing the risk of bias in randomised trials (RoB 2) was used to evaluate the studies' methodological quality. This scoping review's methodology followed the recommendations of the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR).

RESULTS: In all three included RCTs, the PNE intervention resulted in improved Short Form-36 (SF-36) scores. However, one RCT with a low risk of bias found no significant advantage to additional PNE treatment compared to physiotherapy alone. A second RCT raised concerns about the risk of bias; in this study, PNE treatment was superior to a conventional educational intervention. The third RCT, which had a high risk of bias, observed significant improvements in quality of life after both PNE treatment and myofascial induction therapy (MIT). However, the outcome was significantly better with MIT.

CONCLUSION: Overall, the evidence supporting the use of PNE to improve quality of life in patients with chronic low back pain is weak. Therefore, it remains unclear whether PNE can be used to achieve this goal. Further RCTs with subsequent systematic reviews are needed to make clear recommendations for practitioners.

PMID:41817754 | DOI:10.1007/s00482-026-00929-6