Pain neuroscience education: state of the art and application in pediatrics
Open accessAbstract
Chronic pain is a widespread problem in the field of pediatrics. Many interventions to ameliorate pain-related dysfunction have a biobehavioral focus. As treatments for chronic pain (e.g., increased movement) often stand in stark contrast to treatments for an acute injury (e.g., rest), providing a solid rationale for treatment is necessary to gain patient and parent buy-in. Most pain treatment interventions incorporate psychoeducation, or pain neuroscience education (PNE), as an essential component, and in some cases, as a stand-alone approach. The current topical review focuses on the state of pain neuroscience education and its application to pediatric chronic pain. As very little research has examined pain neuroscience education in pediatrics, we aim to describe this emerging area and catalyze further work on this important topic. As the present literature has generally focused on adults with chronic pain, pain neuroscience education merits further attention in the realm of pediatric pain in order to be tailored and implemented in this population.
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Emerging brief psychological interventions for pediatric chronic pain are feasible, acceptable and effective in improving functioning and psychological well-being.
“Emerging brief psychological interventions for pediatric chronic pain have been reported as being feasible, acceptable and effective in improving functioning and psychological well-being”
From The Effect of a Brief Physician-Delivered Neurobiologically Oriented, Cognitive Behavioural Therapy (Brief-CBT) Intervention on Chronic Pain Acceptance in Youth with Chronic Pain—A Randomized Controlled Trial. (2022) · cites this paper as [24]
Section 3.2 reports that psychological therapies for pediatric chronic pain generally outperformed education on functional disability and pain symptoms. It does not establish that the interventions were brief or feasible and acceptable, or that they improved psychological well-being. Section 5 also describes pediatric pain-neuroscience education as an area needing further research. (LLM, conf=0.84)
Experimental — accuracy not yet measuredThis form of pain education was developed in Australia and has been adapted in numerous Western countries, demonstrating mixed results for effectiveness for managing LBP.
“This form of pain education (widely known as ‘Explain Pain’ or ‘Pain Neuroscience Education’)15–24 was developed in Australia and has been adapted in numerous Western countries, demonstrating mixed results for effectiveness for managing LBP.15 17 21 23–25”
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MethodGlobal disruption of degree rank order: a hallmark of chronic pain
Mansour, A. R., Baria, A. T., Tétreault, P., Vachon‐Presseau, É., Chang, P., Huang, L., Apkarian, A. V., & Baliki, M. N. (2016) · Scientific Reports · doi:10.1038/srep34853 · Cited by 102 · cited 1× · see citing works
“The biological component of the biopsychosocial model largely revolves around the complex interplay of several cortical and subcortical brain regions involved in sensory, motor, cognitive, affective, and motivational functions [23]; with recent data suggestive of global brain connectivity reorganization among chronic…”
BackgroundKnow Pain, Know Gain? A Perspective on Pain Neuroscience Education in Physical Therapy
Louw, A., Puentedura, E. J., Zimney, K. J., & Schmidt, S. G. (2016) · Journal of Orthopaedic and Sports Physical Therapy · doi:10.2519/jospt.2016.0602 · Cited by 100 · cited 1× · see citing works
“PNE can be taught as an intervention on its own, as well as in combination with another form of therapy (such as cognitive-behavioral or physical) [5].”
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“validated [38] for youth with chronic pain (Figure 3).”
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“Moreover, adult patients who are unsure of the diagnosis of their pain problem or perceive their pain as enduring and mysterious display higher levels of catastrophizing and are less likely to use coping strategies to deal with their pain [13,14].”
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van Ittersum, M. W., van Wilgen, C. P., van der Schans, C. P., Lambrecht, L., Groothoff, J. W., & Nijs, J. (2014) · Pain Practice · doi:10.1111/papr.12137 · Cited by 79 · cited 2× · see citing works
“In a group of adult fibromyalgia patients, written education alone did not significantly impact pain catastrophizing or functioning during daily tasks [74].”
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Noel, M. E., Palermo, T. M., Chambers, C. T., Taddio, A., & Hermann, C. (2015) · Pain · doi:10.1016/j.pain.0000000000000001 · Cited by 78 · see citing works
A randomized trial of a representational intervention to decrease cancer pain (RIDCancerPain).
Ward, S. E., Donovan, H. S., Gunnarsdóttir, S., Serlin, R. C., Shapiro, G. R., & Hughes, S. (2008) · Health Psychology · doi:10.1037/0278-6133.27.1.59 · Cited by 74 · cited 2× · see citing works
“Similar to PNET is the program RIDcancerPain (The Representational Intervention to Decrease Cancer Pain), that has been used as part of an RCT among adults with cancer pain [28].”
MethodLouw, A., Butler, D. S., Diener, I., & Puentedura, E. J. (2013) · American Journal of Physical Medicine & Rehabilitation · doi:10.1097/phm.0b013e3182876aa4 · Cited by 63 · cited 1× · see citing works
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“In another, parent-focused study [11], parents received either threatening information (stimulus described as painful and barely tolerable, high pain expressions depicted) or non-threatening information (stimulus described as slightly unpleasant, low pain expressions depicted) about a heat stimulus their child would r…”
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“For simplicity, we will refer to these approaches broadly as pain neuroscience education (PNE) [4], unless describing”
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“Five dimensions of these cognitions have been identified and include: (1) identity (the effort to evaluate symptoms and label the illness); (2) cause (the subjectively formulated belief of what is causing the symptoms); (3) time-line (the patient’s perception of how long the problem will last); (4) consequences (the p…”
BackgroundPerspectives on the clinical significance of functional pain syndromes in children
Simons, L. E., Basch, M. C., Chow, E., Logan, D. E., & Schechter, N. L. (2015) · Journal of Pain Research · doi:10.2147/jpr.s55586 · Cited by 26 · cited 1× · see citing works
“The biomedical model has now largely been replaced with a biopsychosocial model, which incorporates all of the aspects in a patient’s life that converge and potentially maintain a cycle of pain [21].”
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“In one study [10], non-patient children completing a CPT received either threatening CPT information (CPT described as very painful, high pain expressions depicted) or non-threatening CPT information (standard CPT instructions provided, low pain expressions depicted).”
BackgroundEffects of a psychoeducational program for chronic pain management
Salvetti, M. D. G., Cobelo, A., Vernalha, P. D. M., Vianna, C. I. D. A., Canarezi, L. C. C. C. C., & Calegare, R. G. L. (2012) · Revista Latino-Americana de Enfermagem · doi:10.1590/s0104-11692012000500011 · Cited by 22 · cited 1× · see citing works
“A similar program was implemented in Brazil, where patients (n = 79) received one hour of stretching alongside a physiotherapist and one hour of CBT-focused psychoeducation with a nurse and psychologist, weekly for eight weeks [56].”
MethodAbram, H. S., Buckloh, L. M., Schilling, L. M., Wiltrout, S. A., Ramírez-Garnica, G., & Turk, W. R. (2007) · Children s Health Care · doi:10.1080/02739610701377939 · Cited by 20 · cited 3× · see citing works
“The RCT by Abram and colleagues [42] described above delivered psychoeducation within a group setting, and revealed some positive effects.”
BackgroundInfluentialCommon Sense Model of Illness in Youth With Type 1 Diabetes or Sickle Cell Disease
Huston, S. A., & Houk, C. P. (2011) · The Journal of Pediatric Pharmacology and Therapeutics · doi:10.5863/1551-6776-16.4.270 · Cited by 20 · cited 2× · see citing works
“disease, conditions which are often accompanied by frequent pain [36].”
BackgroundPractical management of functional abdominal pain in children
Brown, L. K., Beattie, R. M., & Tighe, M. P. (2015) · Archives of Disease in Childhood · doi:10.1136/archdischild-2014-306426 · Cited by 18 · cited 4× · see citing works
“the biopsychosocial model was highlighted in a recent case study of a nine-year-old girl with functional abdominal pain [35].”
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Diagnosis versus Dialogue: Oral Testimony and the Study of Pediatric Pain
Nutkiewicz, M. (2008) · The Oral History Review · doi:10.1093/ohr/ohm002 · Cited by 17 · cited 1× · see citing works
“The oral testimonies of patients at the Pediatric Pain Clinic at UCLA revealed patient frustration regarding the doctor’s lack of interest in their experience [18].”
BackgroundTherapeutic Neuroscience Education, Pain, Physiotherapy and the Pain Neuromatrix
Louw, A., & Puentedura, E. J. (2014) · International Journal of Health Sciences (IJHS) · doi:10.15640/ijhs.v2n3a4 · Cited by 17 · see citing works
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“Loeser has described pain as an onion consisting of four layered components: nociception, pain, suffering, and pain behavior [29] (Figure 1).”
Backgroundvan Ittersum, M. W., van Wilgen, C. P., Groothoff, J. W., & van der Schans, C. P. (2010) · Patient Education and Counseling · doi:10.1016/j.pec.2010.09.006 · Cited by 16 · cited 2× · see citing works
“Even if patients may appreciate receiving written PNE, for it to truly be an agent of change, it may need to be delivered in person to provide an engaging, interactive format, or incorporated into a larger treatment plan that targets multiple elements of the biopsychosocial model [75].”
BackgroundPerspectives on the clinical significance of functional pain syndromes in children
Basch, M. C., Chow, E., Logan, D. E., Schechter, N. L., & Simons, L. E. (2015) · Dove Medical Press (Taylor and Francis Group) · Cited by 15 · see citing works
Self-citationWilson, D., Mackintosh, S. F., Nicholas, M. K., & Moseley, G. L. (2016) · Pain Management · doi:10.2217/pmt.15.66 · Cited by 14 · cited 1× · see citing works
“Moreover, there are several issues to consider in relation to group composition that can potentially impact outcomes, such as size of the group, homogeneity/heterogeneity, and age (see recent review [79]).”
BackgroundHandbook of Pediatric Chronic Pain
(2011) · Springer eBooks · doi:10.1007/978-1-4419-0350-1 · Cited by 5 · see citing works
Managing Your Child's Chronic Pain (DRAFT)
Palermo, T. M., & Law, E. F. (2015) · Oxford University Press eBooks · doi:10.1093/med:psych/9780199330041.001.0001 · Cited by 4 · cited 1× · see citing works
“More recent contributions include “Managing Your Child’s Chronic Pain” [78], which provides parents with insight on CBT strategies as well as vignettes and stories of patient and family experiences, and “When your child hurts,” [34], which provides extensive PNE (over 30 pages dedicated to “Understanding What Pain is…”
BackgroundTheories on Common Adolescent Pain Syndromes
Chorney, J. M. L., Crofton, K., & McClain, B. C. (2011) · Springer eBooks · doi:10.1007/978-1-4419-0350-1_3 · Cited by 3 · cited 1× · see citing works
“Thus, pain was thought to be a direct response to injury, and psychological or behavioural issues were thought to arise as a consequence of pain but not to influence the pain itself [19].”
Background
Flagged first, then by citations
1 of the 68 references couldn’t be matched to a known paper.
Research works printed but not linked: 2
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Cited by
Sorted by citations
Delivering transformative action in paediatric pain: a Lancet Child & Adolescent Health Commission
Eccleston, C., Fisher, E., Howard, R. F., Slater, R., Forgeron, P. A., Palermo, T. M., Birnie, K. A., Anderson, B. J., Chambers, C. T., Crombez, G., et al. (2020) · The Lancet Child & Adolescent Health · doi:10.1016/s2352-4642(20)30277-7 · Cited by 338 · see citing works
Best-evidence for the rehabilitation of chronic pain part 1: Pediatric pain
Harrison, L. E., Pate, J. W., Richardson, P. A., Ickmans, K., Wicksell, R. K., & Simons, L. E. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8091267 · Cited by 140 · see citing works
Self-citationDiagnostic uncertainty in youth with chronic pain and their parents
Neville, A., Jordan, A., Beveridge, J. K., Pincus, T., & Noel, M. (2019) · The Journal of Pain · doi:10.1016/j.jpain.2019.03.004 · Cited by 124 · see citing works
Pain neuroscience education on YouTube
Heathcote, L. C., Pate, J. W., Park, A. L., Leake, H. B., Moseley, G. L., Kronman, C. A., Fischer, M. D., Timmers, I., & Simons, L. E. (2019) · PeerJ · doi:10.7717/peerj.6603 · Cited by 66 · see citing works
“The rapid progress in this field is reflected in the multiple terms now used to describe pain education, including ‘pain neuroscience education’, ‘pain biology education’, ‘therapeutic neuroscience education’, ‘neurophysiological pain education’, and ‘Explaining Pain’ (Robins et al., 2016).”
BackgroundSelf-citationBonilla, D. A., Cardozo, L. A., Vélez-Gutiérrez, J. M., Arévalo-Rodríguez, A., Vargas-Molina, S., Stout, J. R., Kreider, R. B., & Petro, J. L. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191912710 · Cited by 73 · see citing works
Sharma, S., Jensen, M. P., Moseley, G. L., & Abbott, J. H. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-026874 · Cited by 61 · see citing works
Coakley, R., Wihak, T., Kossowsky, J., Iversen, C., & Donado, C. (2018) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsx112 · Cited by 59 · see citing works
Exploring the concept of pain of Australian children with and without pain: qualitative study
Pate, J. W., Noblet, T., Hush, J. M., Hancock, M. J., Sandells, R., Pounder, M., & Pacey, V. (2019) · BMJ Open · doi:10.1136/bmjopen-2019-033199 · Cited by 47 · see citing works
“18 Limited research has been conducted that focuses on a child’s concept of pain.”
Perceived diagnostic uncertainty in pediatric chronic pain
Pincus, T., Noel, M., Jordan, A., & Serbic, D. (2018) · Pain · doi:10.1097/j.pain.0000000000001180 · Cited by 43 · see citing works
Reid, K., Hartling, L., Ali, S., Le, A., Norris, A., & Scott, S. D. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.8877 · Cited by 42 · see citing works
Sidiq, M., Muzaffar, T., Janakiraman, B., Masoodi, S. R., Vasanthi, R. K., Ramachandran, A., Bansal, N., Chahal, A., Kashoo, F. Z., Rizvi, M. R., et al. (2024) · PLoS ONE · doi:10.1371/journal.pone.0294302 · Cited by 47 · see citing works
Integrated Behavioral Health Care in Pediatric Subspecialty Clinics
Samsel, C. B., Ribeiro, M., Ibeziako, P. I., & DeMaso, D. R. (2017) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2017.06.004 · Cited by 37 · see citing works
Hyperexcitability of the Central Nervous System in Children with Chronic Pain: A Systematic Review
Pas, R., Ickmans, K., Oosterwijck, S. V., der Cruyssen, K. V., Foubert, A., Leysen, L., Nijs, J., & Meeus, M. (2017) · Pain Medicine · doi:10.1093/pm/pnx320 · Cited by 36 · see citing works
Pate, J. W., Heathcote, L. C., Simons, L. E., Leake, H. B., & Moseley, G. L. (2020) · Paediatric and Neonatal Pain · doi:10.1002/pne2.12015 · Cited by 36 · see citing works
Self-citationPas, R., Rheel, E., Oosterwijck, S. V., Foubert, A., Pauw, R. D., Leysen, L., Roete, A., Nijs, J., Meeus, M., & Ickmans, K. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9061797 · Cited by 33 · see citing works
‘Drawing a line in the sand’: Physician diagnostic uncertainty in paediatric chronic pain
Neville, A., Noel, M. E., Clinch, J., Pincus, T., & Jordan, A. L. (2020) · European Journal of Pain · doi:10.1002/ejp.1682 · Cited by 33 · see citing works
“pain neuroscience education), and tailor this explanation to the developmental stage of the child, has been identified as a critical area of future research (Robins et al., 2016) and may have an important impact on alignment of physician and patient agendas.”
Backgrounddos Reis, F. J. J., Palermo, T. M., Fernandes, L. A. P. P., Nogueira, L. A. C., Meziat‐Filho, N., Louw, A., & Ickmans, K. (2021) · Brazilian Journal of Physical Therapy · doi:10.1016/j.bjpt.2021.04.009 · Cited by 36 · see citing works
A Child’s Concept of Pain: An International Survey of Pediatric Pain Experts
Pate, J., Hush, J. M., Hancock, M. J., Moseley, G. L., Butler, D. S., Simons, L. E., & Pacey, V. (2018) · Children · doi:10.3390/children5010012 · Cited by 34 · see citing works
Self-citationPas, R., Meeus, M., Malfliet, A., Baert, I., Oosterwijck, S. V., Leysen, L., Nijs, J., & Ickmans, K. (2018) · Brazilian Journal of Physical Therapy · doi:10.1016/j.bjpt.2018.02.004 · Cited by 32 · see citing works
“Most published books about pain in children include some explanation about the neurophysiology of pain, but have been directed towards parents of youth with chronic pain.(29) Even though these books might be useful for parents in providing them valuable insight to help their child manage chronic pain, the PNE content…”
BackgroundCommunicating with Youth about Pain: Developmental Considerations
Emerson, N. D., & Bursch, B. (2020) · Children · doi:10.3390/children7100184 · Cited by 31 · see citing works
The Concept of Pain Inventory (COPI)
Pate, J. W., Simons, L. E., Hancock, M. J., Hush, J. M., Noblet, T., Pounder, M., & Pacey, V. (2020) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000000884 · Cited by 29 · see citing works
“Back 20 (16) 7 (9) Leg/foot 57 (46) 34 (44) Other 18 (15) 10 (13)”
Self-citationKoechlin, H., Locher, C., & Prchal, A. (2020) · Children · doi:10.3390/children7100179 · Cited by 29 · see citing works
Chronic non-cancer pain in children: we have a problem, but also solutions
Vega, E., Beaulieu, Y., Gauvin, R., Ferland, C. E., Stabile, S., Pitt, R., Cárdenas, V. H. G., & Ingelmo, P. M. (2018) · Minerva Anestesiologica · doi:10.23736/s0375-9393.18.12367-4 · Cited by 28 · see citing works
Andias, R., Sá‐Couto, P., & Silva, A. G. (2022) · Physical Therapy · doi:10.1093/ptj/pzac048 · Cited by 28 · see citing works
Psychologically-informed video reduces maladaptive beliefs in adolescents with patellofemoral pain.
Selhorst, M., Hoehn, J., Degenhart, T., Schmitt, L. C., & Fernandez-Fernandez, A. (2019) · Physical Therapy in Sport · doi:10.1016/j.ptsp.2019.10.009 · Cited by 21 · see citing works
Walker, L. S., Stone, A. L., Han, G. T., Garber, J., Bruehl, S. P., Smith, C. A., Anderson, J., & Palermo, T. M. (2021) · Pain · doi:10.1097/j.pain.0000000000002288 · Cited by 23 · see citing works
Communicating with children about ‘everyday’ pain and injury: A Delphi study
Wallwork, S. B., Noel, M. E., & Moseley, G. L. (2022) · European Journal of Pain · doi:10.1002/ejp.2008 · Cited by 21 · see citing works
“Prosocial behaviour and empathy are often encouraged by caregivers to promote social development in children, and the strategies raised align with recent evidence (Spinrad & Gal, 2018).”
ResultTopical Review: Pain in Survivors of Pediatric Cancer: Applying a Prevention Framework
Stone, A. L., Karlson, C., Heathcote, L. C., Rosenberg, A. R., & Palermo, T. M. (2017) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsx114 · Cited by 23 · see citing works
Self-citationKanstrup, M., Jordan, A., & Kemani, M. K. (2019) · Children · doi:10.3390/children6090101 · Cited by 19 · see citing works
Andrews, N. E., Ireland, D., Vijayakumar, P., Burvill, L., Hay, E., Westerman, D., Rose, T., Schlumpf, M., Strong, J., & Claus, A. P. (2023) · JMIR Formative Research · doi:10.2196/47267 · Cited by 18 · see citing works
Olivier, A. (2022) · Phenomenology and the Cognitive Sciences · doi:10.1007/s11097-022-09879-7 · Cited by 20 · see citing works
“53 Louw et al., 2019a, Robins et al., 2016, Wood and Hendrick, 2019.”
InfluentialSpreading the word: pediatric pain education from treatment to prevention
Ickmans, K., Rheel, E., Rezende, J., & dos Reis, F. J. J. (2022) · Archives of Physiotherapy · doi:10.1186/s40945-022-00151-4 · Cited by 18 · see citing works
Cong, X. S., Ramesh, D., Perry, M., Xu, W., Bernier, K. M., Young, E. E., Walsh, S. J., & Starkweather, A. R. (2018) · Research in Nursing & Health · doi:10.1002/nur.21862 · Cited by 16 · see citing works
Perspective: update on pain education
Hogans, B. B., Watt‐Watson, J., Wilkinson, P., Carr, E., & Gordon, D. B. (2018) · Pain · doi:10.1097/j.pain.0000000000001297 · Cited by 16 · see citing works
Pack, R., Gilliland, R., & Mecham, A. (2018) · Physiotherapy Theory and Practice · doi:10.1080/09593985.2018.1551454 · Cited by 16 · see citing works
Pintó, P. B., Ickmans, K., Rheel, E., Iwens, M., Meeus, M., Nijs, J., & Pas, R. (2021) · Children · doi:10.3390/children8050420 · Cited by 15 · see citing works
Hurtubise, K., Brousselle, A., Noel, M. E., Jordan, A. L., White, J. L., Rasic, N. F., & Camden, C. (2020) · Canadian Journal of Pain · doi:10.1080/24740527.2020.1858709 · Cited by 14 · see citing works
“Although the benefits of pain education have been acknowledged in the adult pain literature,(63) evidence in the pediatric population is nascent.(15,19,64,65)”
BackgroundApplicability of pain neuroscience education: Where are we now?
Barbari, V., Storari, L., Maselli, F., & Testa, M. (2021) · Journal of Back and Musculoskeletal Rehabilitation · doi:10.3233/bmr-200091 · Cited by 14 · see citing works
Birnie, K. A., Stinson, J., Isaac, L., Tyrrell, J., Campbell, F., Jordan, I. P., Marianayagam, J., Richards, D., Rosenbloom, B. N., Clement, F., et al. (2022) · Canadian Journal of Pain · doi:10.1080/24740527.2022.2038031 · Cited by 13 · see citing works
Fechner, R., Verhagen, A. P., Alcock, M., Norton, J., Stubbs, P. W., Harrison, L. E., & Pate, J. W. (2024) · Journal of Pain · doi:10.1016/j.jpain.2024.104578 · Cited by 12 · see citing works
Najem, C., Wijma, A. J., Meeus, M., Cagnie, B. J., Ayoubi, F., Oosterwijck, J. V., Meulemeester, K. D., & van Wilgen, C. P. (2023) · Disability and Rehabilitation · doi:10.1080/09638288.2023.2168076 · Cited by 12 · see citing works
“PNE will serve to enhance the lack of skills regarding pain knowledge and the BPS model in both educational programs and everyday clinical settings [54,58].”
BackgroundSalvat, I., Adillón, C., Andres, E. M., Monterde, S., & Miró, J. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18073821 · Cited by 11 · see citing works
Healthcare Professionals’ Knowledge about Pediatric Chronic Pain: A Systematic Review
Pico, M., Matey-Rodríguez, C., Domínguez-García, A., Menéndez, H., Lista, S., & Santos‐Lozano, A. (2023) · Children · doi:10.3390/children10040665 · Cited by 11 · see citing works
Battaglia, M., Groenewald, C. B., Campbell, F. A., Scaini, S., Koninck, Y. D., Stinson, J., & Quinn, P. D. (2023) · Journal of Psychopharmacology · doi:10.1177/02698811221144635 · Cited by 10 · see citing works
“…is also growing recognition of the need for pain neuroscience educational sessions for children and adolescents with chronic pain and families to help them understand the differences between acute and chronic pain and the need for multi-modal, multidisciplinary approaches (Robins et al., 2016).”
BackgroundChronic non-cancer pain in adolescents: a narrative review
Silva, C., de Oliveira, D. A. C., Pestana‐Santos, M., Portugal, F., & Capelo, P. (2021) · Brazilian Journal of Anesthesiology (English Edition) · doi:10.1016/j.bjane.2021.04.033 · Cited by 10 · see citing works
Integrative pediatric pain management: Impact & implications of a novel interdisciplinary curriculum
Matthews, J., Zoffness, R. J., & Becker, D. B. (2021) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2021.102721 · Cited by 8 · see citing works
Simons, L. E., Moayedi, M., Coghill, R. C., Stinson, J., Angst, M. S., Aghaeepour, N., Gaudilliere, B. L., King, C. D., López‐Solà, M., Hoeppli, M., et al. (2022) · BMJ Open · doi:10.1136/bmjopen-2022-061548 · Cited by 6 · see citing works
Self-citationWickering, L., Lautwein, C., Nitsche, H., Schneider, M., & Hechler, T. (2023) · Children · doi:10.3390/children10050814 · Cited by 6 · see citing works
Pain science education for children living with and beyond cancer: Challenges and research agenda
Rheel, E., Heathcote, L. C., ten Bosch, J. V. D. W., Schulte, F., & Pate, J. W. (2022) · Pediatric Blood & Cancer · doi:10.1002/pbc.29783 · Cited by 6 · see citing works
Self-citationSpekking, K., Anink, J., de Boer, P., Bergstra, S. A., van den Berg, J. M., Schonenberg‐Meinema, D., van Suijlekom‐Smit, L. W. A., van Rossum, M. A. J., Koopman-Keemink, Y., Cate, R. T., et al. (2023) · Pediatric Rheumatology · doi:10.1186/s12969-023-00874-z · Cited by 6 · see citing works
Heathcote, L. C., Allen, J. M., Gunn, K. M., Fox, S., Harvie, D. S., Olver, I., Skinner, I., Smith, A., Stanton, T. R., Whitford, H. S., et al. (2019) · Journal of Adolescent and Young Adult Oncology · doi:10.1089/jayao.2019.0047 · Cited by 6 · see citing works
Self-citationCırık, V. A., Bulut, E., Aksoy, B., Cömert, H. S. Y., & Pate, J. W. (2022) · Journal of Pediatric Nursing · doi:10.1016/j.pedn.2022.05.019 · Cited by 5 · see citing works
Lendraitienė, E., Styraitė, B., Šakalienė, R., Misytė, G., & Bilevičiūtė-Ljungar, I. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13072081 · Cited by 5 · see citing works
“Specifically, PNE includes education about patient perceptions of the cause of pain, the onset of pain, and how to reduce pain [18].”
BackgroundTechnology to Assess and Treat Pain in Pediatric Rheumatology
Connelly, M. A., & Lee, R. R. (2021) · Rheumatic Disease Clinics of North America · doi:10.1016/j.rdc.2021.09.004 · Cited by 4 · see citing works
Cortical Changes as a Result of Sports Injuries: A Short Commentary
Vélez-Gutiérrez, J. M., Petro, J. L., Corona, J. A. A., Vargas-Molina, S., Kreider, R. B., & Bonilla, D. A. (2022) · Cuerpo Cultura y Movimiento · doi:10.15332/2422474x.7884 · Cited by 4 · see citing works
Pain neuroscience education on YouTube: a systematic reviewPreprint
Heathcote, L. C., Pate, J. W., Park, A. L., Leake, H. B., Moseley, G. L., Kronman, C. A., Fischer, M. D., Timmers, I., & Simons, L. E. (2018) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/492967 · Cited by 4 · see citing works
Self-citationContents and delivery methods of pain neuroscience education in pediatrics: A scoping review
Rezende, J., Fernandes, L. A. P. P., Nogueira, L. A. C., Meziat‐Filho, N., Ickmans, K., & dos Reis, F. J. J. (2024) · Musculoskeletal Science and Practice · doi:10.1016/j.msksp.2024.103182 · Cited by 4 · see citing works
Kara, Ö. K., Gürşen, C., Ickmans, K., Rheel, E., Elma, Ö., Çetin, S. Y., Doğan, M., Kutluk, M. G., & Kara, K. (2024) · Journal of Pediatric Nursing · doi:10.1016/j.pedn.2024.09.001 · Cited by 3 · see citing works
Expressed Beliefs about the Cause of Pain in a Pediatric Population: A Qualitative Study
Fernández, L. M., Salvat, I., & Adillón, C. (2023) · Children · doi:10.3390/children10061007 · Cited by 3 · see citing works
Tiong, K., Palmer, G. M., & Jaaniste, T. (2024) · Children · doi:10.3390/children11010126 · Cited by 3 · see citing works
“The way in which key concepts and treatment models are explained to patients and care-givers may contribute to the way in which they engage with an intervention [83].”
BackgroundThe Adolescent Knee Pain (AK-Pain) prognostic tool: protocol for a prospective cohort study
Andreucci, A., Holden, S., Jensen, M. B., & Rathleff, M. S. (2019) · F1000Research · doi:10.12688/f1000research.21740.1 · Cited by 3 · see citing works
Zhang, Y., & Yang, C. (2024) · Medicine · doi:10.1097/md.0000000000040760 · Cited by 2 · see citing works
Nonpharmacologic and Rehabilitative Strategies to Address Chronic Pain
Choi, H. Y. J. (2022) · Primary Care Clinics in Office Practice · doi:10.1016/j.pop.2022.01.006 · Cited by 2 · see citing works
Fernández, L. M., Salvat, I., & Adillón, C. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1423716 · Cited by 2 · see citing works
The Adolescent Knee Pain (AK-Pain) prognostic tool: protocol for a prospective cohort study
Andreucci, A., Holden, S., Jensen, M. B., & Rathleff, M. S. (2020) · F1000Research · doi:10.12688/f1000research.21740.2 · Cited by 2 · see citing works
Lin, Y., & Sager, S. L. (2020) · Springer eBooks · doi:10.1007/978-3-030-39982-5_27 · Cited by 2 · see citing works
Simmonds, M. K., Dick, B. D., Verrier, M. J., Reid, K. L., Jamieson-Lega, K., Balisky, K. J., Davey, A. E., & Freeman, K. M. (2022) · Children · doi:10.3390/children9091293 · Cited by 1 · see citing works
Pate, J. W., Simons, L. E., Moore, E., Norton, J. G., Turbitt, E., Verhagen, A. P., & Pacey, V. (2025) · Pain Research and Management · doi:10.1155/prm/7548771 · Cited by 1 · see citing works
“Current research suggests that educational strategies for children with chronic pain should be individualized using age-appropriate language, addressing specifc misconceptions identifed in an individual child, and employing diferent modalities like storytelling or interactive activities [16].”
Self-citationGuddal, M. H., Johansen, S. K., Riiser, K., Sundar, T. K. B., Skonnord, T., Rathleff, M. S., Dunn, K. M., Smedbråten, K., ∅iestad, B. E., & Jahre, H. (2025) · BMC Health Services Research · doi:10.1186/s12913-025-13654-0 · Cited by 1 · see citing works
“Interventions that encompass self-management education [19, 20], psychological interventions [21–24], and various exercise modalities [20, 25] have shown potential for improving outcomes.”
Combined Pain Neuroscience Education and Progressive Muscle Relaxation for Post-Thoracoscopic Pain
Wang, X., Li, W., Wang, F., Liu, Y., Zhao, Q., Liu, J., & Zhu, Y. (2026) · Pain Management Nursing · doi:10.1016/j.pmn.2026.03.024 · Cited by 1 · see citing works
Through the Glass Bubble: Chronic Pain and the Doctor–Patient Relationship as Perceived by Patients
Sonenberg, N., Davidson, E. M., & Jacoby, R. (2020) · Illness Crisis & Loss · doi:10.1177/1054137320910871 · Cited by 1 · see citing works
“Loeser’s onion model has been widely used in the education of professionals and patients, both within the context of pain relief clinics and outside of it (Atkinson & Zacest, 2016; Loeser, 2006; Robins et al., 2016; Vasudevan, 2015).”
BackgroundMethodFerreira, S. M., Schneider, J. T., Schwade, E., Rodrigues, B. F., Vedoin, C. B., & de Oliveira, C. T. (2021) · Contextos Clínicos · doi:10.4013/ctc.2021.142.15 · Cited by 2 · see citing works
Kratter, C. (2024) · Plastic and Aesthetic Research · doi:10.20517/2347-9264.2023.78 · Cited by 2 · see citing works
Jaaniste, T. (2021) · Children · doi:10.3390/children8090738 · Cited by 1 · see citing works
The burden of words in shoulder pain: A case report of a water polo player
Andreani, A., Lorusso, M., Salomon, M., Paci, M., & Brindisino, F. (2021) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2021.10.013
Child and adolescent psychiatry staff’s knowledge on pain management
Geremek, A., Ruby, L., Lindner, C., Niederberger, U., Schild, U., Jung, M., Soyka, O., & Siniatchkin, M. (2022) · Clinical Child Psychology and Psychiatry · doi:10.1177/13591045221125334
Reply to “Pain neuroscience education for fibromyalgia syndrome”
Saraçoğlu, İ., & Akın, E. (2023) · International Journal of Rheumatic Diseases · doi:10.1111/1756-185x.14633
Walt, A. P., & Parker, R. (2023) · Research Square · doi:10.21203/rs.3.rs-3036868/v1
Pain and Mind-Body Interactions
Bento, S. P., Millis, M. B., & Sieberg, C. B. (2023) · Contemporary pediatric and adolescent sports medicine · doi:10.1007/978-3-031-25126-9_8
Naidoo, T. (2023) · doi:10.51415/10321/4997
“Since the application of PNE is vast, it can be utilised in many different injuries and by numerous health professionals, including; physiotherapists; chiropractors; biokineticists and athletic trainers, which makes its influence on patients viable (Robins et al. 2016).”
BackgroundReducing pain: New approaches, new possibilities, and new ways of understanding the brain
Gray, H. (2023) · Belgrade Philosophical Annual · doi:10.5937/bpa2302007h
Tanios, M. A., Kodsy, M., Fu, E., Dhumak, V., Astley, B., & Elsharkawy, H. A. (2024) · Springer eBooks · doi:10.1007/978-3-031-67648-2_12
Attrition From Pediatric Interdisciplinary Chronic Pain Clinics
Tiong, K., Gorrie, A., Palmer, G. M., Sainsbury, D., & Jaaniste, T. (2025) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000001302
“92,93 Pain science education is widely regarded as being an important part of pediatric pain management 94 – 96 ; however, its bene fi ts in terms of child chronic pain and functional outcomes have, to date, been variable.”
- Authors
- Robins, H., Perron, V., Heathcote, L., & Simons, L.
- Affiliations
- Boston Children's Hospital (US)
- Stanford Medicine (US)
- Corresponding author
- Simons, Laura
- Venue
- Children
- Publisher
- MDPI AG
- Published
- 2016-12-21
- Volume
- 3
- Issue
- 4
- Pages
- 43
- ISSN
- 2227-9067 (ISSN-L)
- PMC
- PMC5184818
- OpenAlex
- W2561211467
- Cited by
- 89
- References
- 68
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 9 · 2023: 14 · 2022: 13 · 2021: 11 · 2020: 11 · 2019: 13 · 2018: 8 · 2017: 5
- FWCI
- 1.34
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Children (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- NICHD (HD083270)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- pain neuroscience education, pediatric chronic pain, psychoeducation, pain management, biobehavioral interventions, treatment rationale
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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