View source for Pain Neuroscience Education (PNE) for Low Back Pain

=== Patient perspective ===
A patient’s treatment perspective involves two main components: the patient’s views about their health (e.g. what the condition is, what its causes are and how serious it is to the patient) and the patient’s values (e.g. what will help them most and how this can be achieved). 

==== Patients values and beliefs ====
Minimal research investigates the patient’s values in learning about their pain. However, a mixed-methods survey found that patients believed PNE was necessary for their improvement of persistent pain. <ref name=":3">Leake H, Moseley G, Stanton T, O'Hagan E, Heathcote L. [https://pubmed.ncbi.nlm.nih.gov/33960326/ What do patients value learning about pain? A mixed-methods survey on the relevance of target concepts after pain science education.] Pain. 2021;162(10):2558-68.</ref> PNE as an intervention provides a coherent biological explanation for how emotions such as stress can initiate a hormonal response which can sensitise neural processes associated with pain.<ref name=":2" /> Pain reconceptualisation helps manage stress and anxiety, limiting the pain induced by these emotions. Although there’s limited research in this area, the mixed-methods review provides contextualised insight into qualitative data on the research question, providing a foundation for refining PNE to focus on pain concepts deemed most valuable to people with pain and use patient-centred language to best communicate the concepts.

A common belief that follows pain is the concept that pain means damage; therefore, learning that pain does not indicate bodily or tissue damage can help manage patients’ pain. <ref name=":3" /> These findings are consistent with the [[Fear Avoidance Model|fear-avoidance model]], which describes how individuals may develop musculoskeletal pain due to avoidant behaviour based on fear. <ref>Vlaeyen JWS, Crombez G, Linton SJ. [https://pubmed.ncbi.nlm.nih.gov/27428892/ The fear-avoidance model of pain.] Pain. 2016 Aug;157(8):1588-89.</ref> When a patient is gradually exposed to fear situations, understanding fear-avoidance concept leads to less fear of injury and less avoidance of movement and behaviours. If a patient engages, pain may become less threatening, changing their priority from pain control to valued life goals, e.g., decreasing disability and kinesiophobia, through using positive connotations such as "understanding that even though it hurts, it is not a sign of damage". <ref name=":2" /><ref>Louw A, Diener I, Butler D, Puentedura E. [https://pubmed.ncbi.nlm.nih.gov/22133255/ The effect of neuroscience education on pain, disability, anxiety, and stress in chronic musculoskeletal pain.] Arch Phys Med Rehabil. 2011; 92(12):2041-56.</ref>