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Pain Neuroscience Education

Pain Neuroscience Education

Date: July 12, 2023


What if I told you if after you hurt your back that if you watched this video your narcotic pain medication use, pain score, ER visits and surgical consultations would be more than 70% less than those who did not watch this video?1 This is the case for those who experience pain neuroscience education (PNE). Pain neuroscience education is a strategy that is used in the teaching of pain that focuses on the pain experience and the biological and physiological processes.2

Our therapists have completed a course, some their second course, with the world-renowned pain science expert Adriaan Louw to better help our patients’ outcomes and overall patient care. But what is PNE that our therapists have spent their weekend working on continuing their education?

What is PNE?

PNE is an education strategy, especially when used in conjunction with a physical treatment, that can help decrease pain ratings, fear avoidance, limitations in movement and overall utilization of healthcare services2. This combination with a physical treatment is PNE+ and could consist of nutrition, breathing, aerobic exercise, aquatic therapy, manual therapy etc. There are 22 different strategies that the patient can choose to utilize in combination with the educational strategy. The educational strategy the therapists utilize is individualized to the type of pain or dysfunction that the patient is experiencing at the time.

PNE and medication use?

                PNE has been shown to aid in decreasing use of pain medication. This includes both opioids as well as Gabapentin or Antidepressants (SSRIs) for pain2. To cause a 50% reduction in pain, PNE would have to be a treatment for 3 people for 1 person to get a 50% reduction. However, Gabapentin requires treating 6 people and SSRIs require treating 7 people2. But why does it matter that you can see an improvement in fewer people with PNE compared to medication? 80% of opioids and 999% of the global hydrocodone supply are consumed by Americans.5 There is also an association with increased overdoses, which means any technique that can decrease the reliance on pain medications, either in their entirety or duration, will be beneficial for the health of the patient, to improve the opioid crisis, and overall improved outcomes for patients.

How can AOST therapists help you?

                Many of our therapists have attended 1, or multiple, of Adriaan Louw’s courses. During these courses, they had the chance to learn about PNE from the expert in the field, practice the techniques with each other, and learn physical treatments that can be used in conjunction with verbal PNE.

                PNE has also been shown to be a useful tool before surgery to help optimize outcomes. This can include feeling better prepared for surgery, their surgery meeting their expectations of outcomes, decreased utilization of healthcare related costs.3 This has also been found to be beneficial for those undergoing total knee replacements improving outcomes and patient satisfaction.4 Research continues to look into the benefit of PNE with other surgeries, including shoulder surgery, but overall it is an effective technique to help with post-operative outcomes.

Schedule an Appointment today

Talk with your therapist about how PNE can benefit you and adding it to your treatment plan. We have therapists who are trained in the principles of PNE at all locations. Whether it is for a condition you are currently experiencing, or if you are scheduled for surgery and want to attend physical therapy for pre-operative PNE and therapy, our therapists are here to help.



1.Louw A, Puentedura EJ, Reed J, Zimney K, Grimm D, Landers MR. A controlled clinical trial of preoperative pain neuroscience education for patients about to undergo total knee arthroplasty. Clinical Rehabilitation. 2019;33(11):1722-1731. doi:10.1177/0269215519857782

  1. Louw, A. Pain Neuroscience Education 101.
  2. Louw, Adriaan PhD, PT*,†; Diener, Ina PhD, PT†; Landers, Merrill R. DPT, PhD, PT‡; Puentedura, Emilio J. DPT, PhD, PT*,‡. Preoperative Pain Neuroscience Education for Lumbar Radiculopathy: A Multicenter Randomized Controlled Trial With 1-Year Follow-up. Spine 39(18):p 1449-1457, August 15, 2014. | DOI: 10.1097/BRS.0000000000000444
  3. Louw, A., et al. (2019). A controlled clinical trial of preoperative pain neuroscience education for patients about to undergo total knee arthroplasty. Clin Rehabil: 269215519857782.
  4. Manchikanti, L., et al., Therapeutic use, abuse, and nonmedical use of opioids: a ten-year perspective. Pain physician, 2010. 13 (5): p. 401-35


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