What is Pain Neuroscience Education for Patients?

More than 450 years ago, Rene Descartes (a famous French philosopher, scientist, and mathematician) invented the Cartesian or biomedical model. Why does this matter to you? Because it’s very likely that the way you think about and feel pain directly relates to this model. For example, you may believe that you experience pain because of being physically injured. Why does your knee hurt? Because you bumped it. Why does your wrist hurt? Because you sprained it. Sound reasonable? 

Well, prepare to have your mind blown. After all these years, many researchers and others have concluded that the Cartesian model is outdated. How so? It doesn’t consider the brain and how it can impact a person’s perception of pain. In reality, the brain can produce pain all by itself even without the presence of a bodily injury. Pretty incredible, right?

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What is Pain Neuroscience Education?

Changing how we think about pain can also change the way we experience it. This is a profound notion, maybe even life-changing, if you struggle with chronic pain. But how do people change their understanding of pain? Naturally, we need to be taught. This is where pain neuroscience education (also referred to as therapeutic neuroscience education) comes in.

What is pain neuroscience education (PNE)? Or, on a broader level, what is chronic pain education for patients? Simply put, pain neuroscience education is a strategy that teaches patients to rethink the way they view pain. Courses typically cover how the brain and nerve cells function in pain and go beyond the typical explanations, like “the tissue in your shoulder is inflamed.”

Pain neuroscience education helps patients better understand why they’re experiencing that pain and what role their brain plays in it. This understanding can then set the stage for more reasonable recovery expectations, reduce fear-avoidance behaviors (like being afraid to move), and generally add to a greater feeling of optimism.

How is Pain Neuroscience Taught?

So what does pain science education for patients actually look like in the doctor’s office or at the hospital after surgery? The primary goal of pain neuroscience education is to teach patients complex concepts about pain in an easy-to-understand format. These topics include hypersensitive nerves, inflammation, how the brain processes pain, and others. This kind of patient education can reduce dependency on pain medications (even highly addictive opioids). It can also help limit the amount of time and money people spend on their condition. At the same time, it can encourage adherence to the doctor’s orders, which helps to ensure better health outcomes. 

Physicians teaching pain neuroscience use simplified and conversational language whenever possible, in addition to utilizing pictures, workbooks, metaphors, questionnaires, and really any tool to bring these concepts down to earth.

An essential part of the pain neuroscience educational approach is encouraging the patient to unlearn specific beliefs they may have about pain (this is called deeducation). People undergoing chronic pain education often need to alter or even replace long held beliefs and concepts  about their body and the origin of their pain.     

It generally takes around four hours for a physician to teach the necessary pain neuroscience concepts to the patient. But these programs can be broken down into multiple, more bite-sized sessions. This type of chronic pain education for patients can also be performed in a group setting or individually.   

What is Pain Reprocessing Therapy?

When it comes to the idea that the brain significantly impacts our pain experience, pain neuroscience education isn’t the only method physicians use to convey this information to their patients. There’s also pain reprocessing therapy (PRT), which aims to break the cycle of chronic pain by retraining how the brain reacts to pain signals from the body. 

After ruling out potential structural causes of the pain and taking common signs of centralized pain into consideration (lack of a physical injury; inconsistent pain, moves around, changes intensity, and/or is triggered by stress; an anxious and/or hypervigilant personality; and childhood trauma), doctors use several techniques  to help patients retrain their brains that include:

• Mindfulness
• A more positive self-narrative
• Focus shifting to positive thoughts during pain episodes.
  

The ultimate goal with pain reprocessing therapy and the steps above is to create and strengthen new neural pathways and associations in the brain between the activity that causes the pain and positive feelings. 

How is Pain Neuroscience Education Different from Pain Reprocessing Therapy? 

In actuality, pain neuroscience education and pain reprocessing therapy work hand-in-hand. They are both based on the idea that sometimes the chronic pain we experience results from our thinking, the hypersensitivity of our nerves, and/or misguided pain processing by the brain. And they are both psychological treatments for chronic pain that aim to lessen the fear that has been found to correlate with pain. 

It might be easiest to think of pain neuroscience education as the umbrella that pain reprocessing therapy falls under. Pain neuroscience education teaches patients about all types of brain-related reasons for pain. Pain reprocessing therapy concentrates on one of those aspects (a hyper-sensitive central nervous system) and educates the patient about how to fix this issue.

Is Neuroscience Education Therapeutic?

First, let’s define what therapeutic means. Therapeutic refers to treatments that help alleviate pain. So is pain neuroscience education a technique that assists in relieving chronic pain? Yes, and not only that, but this educational approach provides other benefits as well (many of which contribute to a reduction in pain):

• It has been shown to reduce fear and catastrophizing (imagining the worst possible outcome) in patients.
• It improves the patient’s beliefs and attitudes about pain.
• It encourages people to move more.
• It helps restore physical functionality and performance.
• It may improve the perception the patient has of physical therapy.
• It boosts the amount of pain people can withstand while performing tasks.
• It encourages patients to stick with their therapeutic treatments.
  

There are clearly a lot of benefits to patients when physicians teach them about their pain via pain neuroscience education (as well as the corresponding pain reprocessing therapy). In both instances, providing pain education for patients has proven to assist them in reconceptualizing their chronic pain and hence being better able to cope with it. At Lin, we recognize how vital pain management education for patients is. Our health coaches incorporate this into the personalized care plans they create with our members. We want to help you move past your pain so that you can experience a whole and active life. Contact us today to learn more!