Acceptance of pain neuroscience education in chronic musculoskeletal pain conditions: qualitative systematic review

Pain Rep. 2026 Mar 19;11(2):e1420. doi: 10.1097/PR9.0000000000001420. eCollection 2026 Apr.

ABSTRACT

Pain neuroscience education (PNE) is a recognized strategy to manage biopsychosocial aspects of chronic pain. To this date, a systematic synthesis of determinants affecting the use and acceptance of PNE in clinical practice is pending. Primary qualitative articles were included if they investigated patient and/or provider perspectives on the use and acceptance of PNE in chronic musculoskeletal pain management. We searched MEDLINE (PubMed), Web of Science, and PsycInfo to identify eligible articles. Two researchers independently conducted the consensus-guided study selection process. Methodological quality was assessed using the Joanna Briggs Institute's (JBI) critical appraisal tool for qualitative research. Data from retrieved articles were synthesized using the JBI meta-aggregation approach. Confidence in findings was assessed by the ConQual approach to synthesized findings. Sixteen studies were included for qualitative meta-aggregation, comprehending perspectives of 329 participants. The analysis revealed 6 synthesized findings: (1) Basic didactic principles such as metaphors, multichannels, repetition, and plain messages support the delivery of PNE; (2) persisting beliefs in biomedical explanations of pain can lead to skepticism and misunderstandings of PNE; (3) emphasize the benefits of PNE and create personal relevance; (4) a group vs an individual setting should be chosen according to patient needs; (5) a good clinician-patient relationship is crucial for the acceptance of PNE; and (6) lacking confidence, unclear responsibilities, and a professional culture focused on biomedical aspects of care can keep practitioners from delivering PNE. Addressing these findings will contribute to a wider use and acceptance of PNE clinical practice.

PMID:41868689 | PMC:PMC13004225 | DOI:10.1097/PR9.0000000000001420