Reconciling movement and exercise with pain neuroscience education: A case for consistent education

Abstract

This article will introduce a conceptual framework of kinesthetic education that is consistent with and reinforces pain neuroscience education. This article will also provide some specific guidance for integrating pain neuroscience education with exercise and movement in a more congruent manner. Our belief is that this will enhance the effectiveness of specific movement approaches such as graded exposure techniques. Over the past decade, a new paradigm of pain education has been explored in an effort to improve patient outcomes. Using advances in pain neuroscience, patients are educated in the biological and physiological processes involved in their pain experience. Growing evidence supports the ability of pain neuroscience education (PNE) to positively impact a person's pain ratings, disability, pain catastrophization, and movement limitations. What is often overlooked, however, is the consistency between the messages of PNE and those of other therapeutic interventions, including movement therapies. This article proposes the following: education provided in isolation will be limited in its impact, the addition of guided purposeful movement performed in a manner consistent with PNE may be vital to the desired behavioral changes, and when inconsistent messages are delivered between education and movement interventions, outcomes may be adversely impacted.

Can Exercise Affect the Pain Characteristics in Patients with Fibromyalgia? A Randomized Controlled Trial

“…The recommendation of the aerobic exercise and breathing combination is not only to increase fitness, but also to provide a way of controlling allodynia and hyperalgesia, which we are aware exists in patients with fibromyalgia. Controlling the pain limit with breathing seems to have an effect because patients who suffer from central pain, such as fibromyalgia [ 18 ], learn through this technique that reaching the point of pain is safe [ 19 , 20 , 21 ]. Deep slow breathing techniques decisively affect autonomic processing and pain thresholds [ 22 ].…”

The association between work-related physical and psychosocial factors and musculoskeletal disorders in healthcare workers: Moderating role of fear of movement

“…The curative sector uses, for example, pain education and graded activity to target FOM and improve physical functioning. 34 , 35 , 36 It might be worthwhile to provide pain education in the management of MSDs at work to employees who struggle with FOM as well as to gradually increase their work activities. Next, our results show that FOM can influence the relationship between work‐related physical and psychosocial factors and MSDs.…”

“…Most of the included studies focused on stress management and ergonomic training, where interventions such as exercise and advice to stay active showed promising results. The curative sector uses, for example, pain education and graded activity to target FOM and improve physical functioning 34‐36 . It might be worthwhile to provide pain education in the management of MSDs at work to employees who struggle with FOM as well as to gradually increase their work activities.…”

Therapeutic management of the painful nerve: a narrative review of common rehabilitation interventions

“…Pain is a complex experience that is influenced by many body systems, and the literature demonstrating the effectiveness of PNE on neuropathic pain is limited. A longitudinal study of 799 subjects by Lee et al demonstrated that 12 months after PNE alone, increased pain biology knowledge was associated with lower pain intensity and catastrophization [38] . Nonetheless, many argue that in isolation, the benefits of PNE are limited and must be accompanied by other interventions and/or physical activity under the guidance of a therapist for best results [39] .…”