PAIN+ CPN

OBJECTIVE: To evaluate the efficacy of therapeutic patient education delivered by a health care provider, either alone or in combination with other rehabilitation interventions, for reducing pain and disability in adults with subacute and chronic musculoskeletal conditions. DESIGN: Intervention systematic review with meta-analysis. LITERATURE SEARCH: Five databases were searched from 2005 to 2025. STUDY SELECTION CRITERIA: Randomized clinical trials (RCTs) evaluating the efficacy of therapeutic patient education in adults with subacute and chronic musculoskeletal conditions, compared to other interventions such as exercise programs. Outcomes included pain, disability, quality of life, kinesiophobia, and catastrophizing. DATA SYNTHESIS: Treatment effects were estimated using random-effects models with standardized mean differences. Risk of bias was assessed using the Cochrane RoB 2.0 tool. Certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. RESULTS: Sixty-nine RCTs were included, and 56 contributed data to meta-analyses (n = 6773 participants; mean age, 43.1 ± 10.3 years; 63% female). Adding therapeutic patient education to other interventions likely reduced pain, disability, and catastrophizing in the short term (moderate-certainty evidence), may reduce pain and disability in the medium term (low-certainty evidence), and likely resulted in a large reduction in kinesiophobia in the short and medium terms (moderate-certainty evidence). The efficacy of therapeutic patient education as a stand-alone intervention was uncertain. CONCLUSION: Evidence supports using therapeutic patient education, in combination with other rehabilitation interventions, to reduce pain, disability, kinesiophobia, and catastrophizing in adults with subacute and chronic musculoskeletal conditions. The magnitude of the effects may vary from small to large. J Orthop Sports Phys Ther 2025;55(10):1-26. Epub 20 August 2025. doi:10.2519/jospt.2025.13247.

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