The DOI matches its Crossref record; 33 of the 33 references it cites were found in a registry or an index.
The impact of combining pain education strategies with physical therapy interventions for patients with chronic pain: A systematic review and meta-analysis of randomized controlled trials
Abstract
Study Design: Systematic Review with meta-analysis.Background: Rehabilitation providers have begun to incorporate pain education into their treatment protocols to influence the patient’s experience and knowledge to improve their condition. The purpose of this systematic review is to determine if the addition of pain education strategies to physical therapy treatments is beneficial in reducing pain intensity and disability for those with chronic musculoskeletal pain.Methods: A systematic database search was conducted for randomized control trials that investigated the concurrent use of pain education and physical therapy. Standardized methods for article identification, inclusion, and quality appraisal was utilized. Where possible, studies were pooled for meta-analysis, with pain and disability as the primary outcomes.Results: Fourteen articles were included in this review, of which all fourteen were rated as high quality using the PEDro scale of quality assessment. Meta-analyses were conducted on pain and disability constructs at short term (< 12 weeks) and long-term (≥ 12 weeks) for the studies that allowed for quantitative pooling of effect sizes. Thirteen out of the fourteen included studies demonstrated a decrease in pain and disability with the use of combined interventions. There was a large effect on short-term pain (SMD 0.837), long-term pain (SMD 0.964), and long-term disability (SMD 1.374). A moderate effect on with short-term disability (SMD 0.791).Conclusion: The results of this systematic review support the conclusion that utilizing pain education strategies in conjunction with interventions provided by physical therapists demonstrates a moderate to large effect sizes on pain and disability constructs but lack pooled statistical significance.
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“In the same light, physical therapies can significantly reduce pain-related distress, especially when applied along with educational interventions [129].”
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Alenezi, A. A., Paudyal, V., & Yahyouche, A. (2025) · Journal of Pain Research · doi:10.2147/jpr.s512418
Slatman, S., van Lankveld, W., Staal, J. B., van Goor, H., Ostelo, R., Westendorp, J., & Knoop, J. (2025) · PEC Innovation · doi:10.1016/j.pecinn.2025.100443
“However, these treatments often only yield small and short-term results [8,9].”
Anselmo-e-Silva, C. I., Santos‐de‐Araújo, A. D., Ferreira-Silva, H., da Silva, E. O., Brito, I. M. D. F., de Oliveira, C. A. M., Melger, M. J. C., Pinto, C. D. M., de Menezes, F. S., & de Sousa, N. T. A. (2025) · BMC Sports Science Medicine and Rehabilitation · doi:10.1186/s13102-025-01451-5
“This has also been observed in individuals with chronic pain [62, 63], such as those affected by patellofemoral pain [64], low back pain [65, 66], and neck pain [67].”
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Kühn, L., Wengemuth, E., Kleist, L., & Choi, K. (2026) · PAIN Reports · doi:10.1097/pr9.0000000000001420
“44 When combined with other multimodal interventions, such as exercise or manual therapy, PNE has been shown to produce the most promising results, 15,31,38,44 a combination often referred to as PNE 1 .”
Ramírez‐García, I., Martínez-García, R., Smet, C. E., Padilla-Fernández, B. Y., Arlandis, S., Castro-Diaz, D. M., Cruz, F., Espuña‐Pons, M., González-Enguita, C., LÓPEZ-FANDO, L. C., et al. (2026) · Continence · doi:10.1016/j.cont.2026.102334
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“25 28 29 Interventions addressing both physical and psychological factors have been shown to improve outcomes in physical function and reduce pain intensity in individuals with chronic pain 30 and low back pain 31 compared with usual care.”
Pain Catastrophizing: Mechanisms and Clinical Implications
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“148 Moreover, lack of adherence is common among patients with chronic conditions.”
Archer, A. B., Noel, J. D. D. S. M., Salinas, J., Nordenflycht, D. D., Cebola, P., Machado, T. T., Tesch, R. D. S., Calcia, T. B. B., de Souza, B. D. M., Melo, G., et al. (2026) · Scientific Reports · doi:10.1038/s41598-026-60271-w
“…pain-related beliefs and attentional patterns—such as cognitive behavioral therapy (thought monitoring), pain education, and graded exposure approaches— which have demonstrated benefits in several other chronic pain conditions and may also be relevant for patients with painful TMD 6,37,38 .”
Beyond the Basics: Cutting-Edge Approaches to Chronic Pelvic Pain Evaluation
Carrillo, J. F., & Castellanos, M. E. (2026) · Clinical Obstetrics & Gynecology · doi:10.1097/grf.0000000000001048
Rasool, A., Naseem, N., Saleem, B., Ghaffar, A., Ehsan, K., & Saeed, U. (2026) · The Healer Journal of Physiotherapy and Rehabilitation Sciences · doi:10.55735/ggtxk802
Metadata
- Authors
- Marris, D., Theophanous, K., Cabezon, P., Dunlap, Z., & Donaldson, M.
- Affiliations
- Walsh University (US)
- Tufts University (US)
- Corresponding author
- Donaldson, Megan
- ORCID
- Donaldson, Megan
- Venue
- Physiotherapy Theory and Practice
- Publisher
- Informa UK Limited
- Published
- 2019-06-28
- Volume
- 37
- Issue
- 4
- Pages
- 461-472
- ISSN
- 0959-3985 (ISSN-L)
- 1532-5040
- OpenAlex
- W2953819207
- Cited by
- 113
- References
- 33
- Citations by year
- 2026: 11 · 2025: 16 · 2024: 31 · 2023: 18 · 2022: 13 · 2021: 15 · 2020: 8 · 2019: 1
- FWCI
- 1.19
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Physiotherapy Theory and Practice (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Keywords
- pain education, physiotherapy, chronic musculoskeletal pain, pain intensity, disability, combined intervention, patient education, rehabilitation
- MeSH terms
- Combined Modality Therapy, Disability Evaluation, Humans, Pain Measurement, Patient Education as Topic, Randomized Controlled Trials as Topic, Physical Therapy Modalities, Chronic Pain, Musculoskeletal Pain
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