Lepri, Beatrice, Romani, Daniele, Storari, Lorenzo et al. · International journal of environmental research and public health · 2023 · DOI
This review looked at 15 studies testing whether pain neuroscience education—teaching patients how pain works in the nervous system—helps people with chronic muscle and joint pain, including those with conditions like fibromyalgia and chronic fatigue syndrome. The research found that this type of education does appear to reduce pain and improve disability and mood, especially when delivered one-on-one and combined with other treatments like physical therapy.
This review is directly relevant to ME/CFS patients because chronic fatigue syndrome is explicitly examined as a central sensitization condition responsive to pain neuroscience education. Understanding non-pharmacological approaches that may improve pain, disability, and psychological well-being could expand treatment options for this severely understudied patient population.
This review does not prove that PNE cures or reverses the underlying pathophysiology of ME/CFS or central sensitization, nor does it establish optimal dosing, timing, or which patient subgroups benefit most. The review acknowledges that most included RCTs lacked rigorous central sensitization diagnostic criteria, so generalizability to well-defined ME/CFS cohorts remains uncertain.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Lepri, Beatrice, Romani, Daniele, Storari, Lorenzo, & Barbari, Valerio (2023). Effectiveness of Pain Neuroscience Education in Patients with Chronic Musculoskeletal Pain and Central Sensitization: A Systematic Review.. International journal of environmental research and public health. https://doi.org/10.3390/ijerph20054098
BibTeX
@article{mecfsatlas-lepri-2023-effectiveness-pain,
author = {Lepri, Beatrice and Romani, Daniele and Storari, Lorenzo and Barbari, Valerio},
title = {Effectiveness of Pain Neuroscience Education in Patients with Chronic Musculoskeletal Pain and Central Sensitization: A Systematic Review.},
journal = {International journal of environmental research and public health},
year = {2023},
doi = {10.3390/ijerph20054098},
note = {PubMed: 36901108},
url = {https://www.mecfsatlas.com/evidence/lepri-2023-effectiveness-pain},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/lepri-2023-effectiveness-pain
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