Chronic Pain and Pain Neuroscience Education (PNE)

Chronic Pain and Pain Neuroscience Education (PNE)

Understand how knowledge can be a powerful tool in managing persistent pain.

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What is Chronic Pain?

Chronic pain is defined as pain that persists beyond the normal healing time (usually >3 months), without a clear cause or with a maladaptive neurosensory component. It is often not directly related to actual tissue damage, but to a hypersensitization of the nervous system.

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What is Pain Neuroscience Education (PNE)?

Pain neuroscience education (PNE) involves explaining to the patient how pain works from a neurobiological and biopsychosocial perspective, helping them understand that:

• Pain does not always indicate actual physical damage.
• The nervous system can be "hypersensitized".
• Emotions, thoughts, and past experiences influence pain perception.
• Physical activity does not always worsen the problem and can be therapeutic.

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Scientific Foundations

Neuroimaging and neurophysiology studies show that:

• Chronic pain activates different brain networks than acute pain.
• There is a dissociation between pain and damage.
• The brain can create pain even without a real noxious stimulus.

Associated changes:

• Central sensitization: The central nervous system becomes more sensitive.
• Negative neuroplasticity: Brain reorganization into patterns that perpetuate pain.
• Catastrophizing and fear of movement (kinesiophobia): Key factors in chronification.

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How is PNE Applied in Physiotherapy?

Educational sessions (individual or group):

• Use of visual analogies and simple language.
• Models such as the "protective brain," "smoke alarm," or "fire control center."

Graded exercise:

• Movement without fear to retrain the system.
• Increase body confidence.

Manual therapy and cognitive techniques:

• Combination with approaches such as manual therapy, breathing, mindfulness, etc.

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Proven Benefits

Studies show that PNE:

• ▼ Reduces pain and disability.
• ▼ Decreases medication use.
• ▼ Decreases fear of movement.
• ✓ Improves treatment adherence.
• ✓ Increases patient empowerment.

Key references:

• Lorimer Moseley & David Butler (Authors of the book "Explain Pain").
• Clinical studies in patients with chronic low back pain, fibromyalgia, postsurgical pain, etc.

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Common Conditions Treated with PNE:

• Chronic low back pain.
• Fibromyalgia.
• Complex regional pain syndrome (CRPS).
• Tension headaches and migraines.
• Persistent postoperative pain.
• Myofascial syndromes.

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Key Phrases of the PNE Approach:

• “Pain does not always mean harm.”
• “The brain can learn to produce pain and can also unlearn it.”
• “Knowledge about pain is a therapeutic intervention in itself.”

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Recommended Resources:

• Book: "Explain Pain" – Butler & Moseley.
• Videos: "Tame the Beast" and "Why Things Hurt" on YouTube.
• Professional training: PNE courses certified by NOI Group.

If you wish, I can prepare a visual PowerPoint presentation, a professional PDF article, or help you translate and adapt this content for Spanish-speaking patients. Would you like something like that?