Journals / İzmir Katip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi / 2026 / Cilt: 11 Sayı: 3

The Effect of Pain Neuroscience Education on Pain and Disability Following Arthroscopic Rotator Cuff Repair: A Narrative Review

Artroskopik Rotator Cuff Tamirinden Sonra Ağrı Nörobilim Eğitimi’nin Ağrı ve Dizabilite Üzerine Etkisi: Geleneksel Derleme

Büşra Aksan Sadıkoğlu(İstanbul Üniversitesi-Cerrahpaşa)0000-0003-0279-9197
Yıldız Analay Akbaba(İSTANBUL ÜNİVERSİTESİ-CERRAHPAŞA)0000-0002-8141-6977
Pages
762–768
Publication Date
2026-09-30
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Additionally, future research should establish the optimal dosage, content, and duration of Pain Neuroscience Education.

📌 3 Key Takeaways

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Objective & Hypothesis:Post-arthroscopic rotator cuff repair pain is common and can be influenced by psychological factors such as pain catastrophizing, anxiety, depression, and kinesiophobia.
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Key Findings & Data:Pain Neuroscience Education is a treatment strategy that helps patients understand the factors influencing pain beliefs and behaviors, aiming to change maladaptive thoughts, such as pain catastrophizing, and improve their understanding of chronic pain.
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Conclusion & Impact:Additionally, future research should establish the optimal dosage, content, and duration of Pain Neuroscience Education.
🔬Design:Review & Systematic Survey
📍Scope:Comprehensive Sample
⚙️Variables:Artroskopik rotator manşet tamiri · Nörobilim eğitimi · Ağrı

Abstract

Post-arthroscopic rotator cuff repair pain is common and can be influenced by psychological factors such as pain catastrophizing, anxiety, depression, and kinesiophobia. Pain Neuroscience Education is a treatment strategy that helps patients understand the factors influencing pain beliefs and behaviors, aiming to change maladaptive thoughts, such as pain catastrophizing, and improve their understanding of chronic pain. The purpose of this review was to examine studies that have applied Pain Neuroscience Education after arthroscopic rotator cuff repair and to determine and summarize the effectiveness of this training in improving pain and disability. A literature search was conducted in PubMed, PEDro, Scopus, and Google Scholar databases to identify clinical studies on arthroscopic rotator cuff repair. Eligible clinical studies investigating the effects of Pain Neuroscience Education on pain and disability after arthroscopic rotator cuff repair were identified from the above databases and a narrative review was performed. According to the findings of the studies, Pain Neuroscience Education has been shown to provide similar improvements in pain and disability compared to biomedical education or standard rehabilitation. However, one study reported a significant improvement of Pain Neuroscience Education pain in movement compared to biomedical education. It appears that the results of Pain Neuroscience Education regarding pain do not show significant advantages over biomedical education or standard rehabilitation, the outcomes related to disability are more promising. Confirming the results requires further studies with larger sample sizes. Additionally, future research should establish the optimal dosage, content, and duration of Pain Neuroscience Education.

Özet

Artroskopik rotator cuff tamiri sonrası ağrı, hastalar için yaygın bir endişe kaynağıdır. Ağrının yanı sıra, ağrıyı felaketleştirme, anksiyete, depresyon ve kinezyofobi gibi faktörler hastalarda duygusal ve bilişsel değişikliklere sebep olabilir. Ağrı Nörobilim Eğitimi, hastalara ağrı deneyimini etkileyen inanç ve davranışlarla ilişkili temel faktörleri öğretmeye odaklanan bir tedavi stratejisidir. Hastayı kronik ağrıyı anlamaya teşvik eder ve ağrıyı felaketleştirme gibi uyumsuz düşünce ve inançları değiştirmeyi amaçlar. Bu derlemenin amacı, artroskopik rotator cuff tamirinden sonra hastalara Ağrı Nörobilim Eğitimi uygulayan çalışmaları incelemek ve bu eğitimin hastaların ağrı ve dizabilitesini iyileştirmedeki etkinliğini belirlemek ve özetlemektir. Artroskopik rotator cuff tamiri ile ilgili klinik çalışmaları belirlemek için PubMed, PEDro, Scopus ve Google Scholar veri tabanlarında bir literatür taraması yapıldı. Yukarıdaki veritabanlarından Ağrı Nörobilim Eğitimi'nin artroskopik rotator cuff tamiri sonrası ağrı ve dizabilite üzerindeki etkilerini araştıran uygun klinik çalışmalar belirlenmiştir ve bir derleme yapılmıştır. Çalışmaların sonuçlarına göre, PNE'nin ağrı ve sakatlık açısından biyomedikal eğitim veya standart rehabilitasyon programları ile benzer iyileşme sağladığı görülmektedir. Bir çalışmada aktivite sırasında ağrıyı iyileştirmede biyomedikal eğitime göre anlamlı fark bulunmuştur. Ağrı Nörobilim Eğitimi'nin ağrı ile ilgili sonuçlarının biyomedikal eğitim veya standart rehabilitasyon programlarına göre önemli avantajlar göstermediği, dizabilite ile ilgili sonuçların daha ümit verici olduğu görülmektedir. Sonuçları doğrulamak için daha büyük örneklem boyutlarına sahip daha fazla çalışmaya ihtiyaç vardır. Ayrıca gelecekteki araştırmalar, Ağrı Nörobilim Eğitimi’nin optimal dozajını, içeriğini ve süresini belirlemelidir.

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Cite This Article

Sadıkoğlu, B. A., Akbaba, Y. A. (2026). The Effect of Pain Neuroscience Education on Pain and Disability Following Arthroscopic Rotator Cuff Repair: A Narrative Review. İzmir Katip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, Cilt: 11 Sayı: 3, 762–768. https://doi.org/10.61399/ikcusbfd.1628819

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References (46)

  1. Yamamoto A, Takagishi K, Osawa T, Yanagawa T, Nakajima D, Shitara H, et al. Prevalence and risk factors of a rotator cuff tear in the general population. J Shoulder Elbow Surg. 2010;19(1):116-20. DOI: 10.1016/j.jse.2009.04.006
  2. Yamaguchi K, Ditsios K, Middleton WD, Hildebolt CF, Galatz LM, Teefey SA. The demographic and morphological features of rotator cuff disease: A comparison of asymptomatic and symptomatic shoulders. J Bone Joint Surg Am. 2006;88(8):1699-704. DOI: 10.2106/JBJS.E.00835.
  3. Ryösä A, Laimi K, Äärimaa V, Lehtimäki K, Kukkonen J, Saltychev M. Surgery or conservative treatment for rotator cuff tear: A meta-analysis. Disabil Rehabil. 2017;39(14):1357-63. DOI: 10.1080/09638288.2016.1198431.
  4. Henn RF III, Kang L, Tashjian RZ, Green A. Patients' preoperative expectations predict the outcome of rotator cuff repair. J Bone Joint Surg Am. 2007;89(9):1913-9. DOI: 10.2106/JBJS.F.00358.
  5. Houck DA, Kraeutler MJ, Schuette HB, McCarty EC, Bravman JT. Early versus delayed motion after rotator cuff repair: A systematic review of overlapping meta-analyses. Am J Sports Med. 2017;45(12):2911-5. DOI: 10.1177/0363546517692543.
  6. Ghodadra NS, Provencher MT, Verma NN, Wilk KE, Romeo AA. Open, mini-open, and all-arthroscopic rotator cuff repair surgery: Indications and implications for rehabilitation. J Orthop Sports Phys Ther. 2009;39(2):81-A6. DOI: 10.2519/jospt.2009.2918.
  7. Conti M, Garofalo R, Delle Rose G, Campi S, Castagna A. Post-operative rehabilitation after surgical repair of the rotator cuff. Chir Organi Mov. 2009;93(Suppl 1):S55-63. DOI: 10.1007/s12306-009-0003-9.
  8. Monesi R, Benedetti MG, Zati A, Basaglia N, Galletti S, Leardini A. The effects of a standard postoperative rehabilitation protocol for arthroscopic rotator cuff repair on pain, function, and health perception. Joints. 2018;6(3):145-52. DOI: 10.1055/s-0038-1673701.
  9. Kennedy P, Joshi R, Dhawan A. The effect of psychosocial factors on outcomes in patients with rotator cuff tears: A systematic review. Arthroscopy. 2019;35(9):2698-706. DOI: 10.1016/j.arthro.2019.03.043.
  10. Louw A, Zimney K, Puentedura EJ, Diener I. The efficacy of pain neuroscience education on musculoskeletal pain: A systematic review of the literature. Physiother Theory Pract. 2016;32(5):332-55. DOI: 10.1080/09593985.2016.1194646.
  11. Andias R, Silva AG, Oliveira F, Araujo J, Casimiro M, Cruz EB. The effects of pain neuroscience education and exercise on pain, muscle endurance, catastrophizing, and anxiety in adolescents with chronic idiopathic neck pain: A school-based pilot, randomized, and controlled study. Physiother Theory Pract. 2018;34(9):682-91. DOI: 10.1080/09593985.2018.1423590.
  12. Siddall B, Ram A, Jones MD, Booth J, Perriman D, Summers SJ. Short-term impact of combining pain neuroscience education with exercise for chronic musculoskeletal pain: A systematic review and meta-analysis. Pain. 2022;163(1):e20-30. DOI: 10.1097/j.pain.0000000000002308.
  13. Larsen JB, Skou ST, Laursen M, Rathleff MS, Bandholm T. Exercise and pain neuroscience education for patients with chronic pain after total knee arthroplasty: A randomized clinical trial. JAMA Netw Open. 2024;7(5):e2412179. DOI: 10.1001/jamanetworkopen.2024.12179.
  14. Dams L, Van der Gucht E, Devoogdt N, Van Goethem A, Groef A, Nijs J. Effect of pain neuroscience education after breast cancer surgery on pain, physical, and emotional functioning: A double-blinded randomized controlled trial (EduCan trial). Pain. 2023;164(7):1489-501. DOI: 10.1097/j.pain.0000000000002838.
  15. Kim H, Lee S. The efficacy of pain neuroscience education on active rehabilitation following arthroscopic rotator cuff repair: A CONSORT-compliant prospective randomized single-blind controlled trial. Brain Sci. 2022;12(6):764. DOI: 10.3390/brainsci12060764.
  16. Ponce-Fuentes F, Cuyul-Vásquez I, Bustos-Medina L, Fuentes J. Effects of pain neuroscience education and rehabilitation following arthroscopic rotator cuff repair. A randomized clinical trial. Physiother Theory Pract. 2023 Sep 2;39(9):1861-70. DOI: 10.1080/09593985.2022.2061394.
  17. Huysmans E, Goudman L, Coppieters I, Van Bogaert W, Moens M, Buyl R, et al. Effect of perioperative pain neuroscience education in people undergoing surgery for lumbar radiculopathy: a multicentre randomised controlled trial. Br J Anaesth. 2023 Sep;131(3):572-85. DOI: 10.1016/j.bja.2023.05.007.
  18. Kararti C, Özyurt F, Kodak Mİ, Basat HÇ, Özsoy G, Özsoy İ, et al. Pain neuroscience education following arthroscopic rotator cuff repair for patients with rotator cuff tears: a double-blind randomized controlled clinical trial. Am J Phys Med Rehabil. 2024 Aug 1;103(8):690-97. DOI: 10.1097/PHM.0000000000002481.
  19. Terzi D, Zeybek A. Rotator cuff syndrome and current approaches in treatment. Namik Kemal Med J. 2021;9(1):1-5. DOI: 10.4274/nkmj.galenos.2020.788853
  20. Demirhan M, Esenyel C. All arthroscopic treatment of rotator cuff tears. Acta Orthop Traumatol Turc. 2003;37:93-104. DOI:10.3944/aott.v37i0.794
  21. Uquillas CA, Capogna BM, Rossy WH, Mahure SA, Rokito AS. Postoperative pain control after arthroscopic rotator cuff repair. J Shoulder Elbow Surg. 2016;25(7):1204-13. DOI: 10.1016/j.jse.2016.01.026.
  22. Özyürek S, Turan K, Çabuk H. Artroskopik tam kat rotator manşet tamiri ve klinik sonuçları. TOTBİD Dergisi. 2021;9(1):1-5. DOI: 10.5578/totbid.dergisi.2022.24
  23. Sole G, Mącznik AK, Ribeiro DC, Jayakaran P, Wassinger CA. Perspectives of participants with rotator cuff-related pain to a neuroscience-informed pain education session: an exploratory mixed method study. Disabil Rehabil. 2020 Jun;42(13):1870-79. DOI: 10.1080/09638288.2018.1542037.
  24. Powell JK, Lewis JS. Rotator cuff-related shoulder pain: Is it time to reframe the advice, "You need to strengthen your shoulder"? J Orthop Sports Phys Ther. 2021;51(4):156-8. DOI: 10.2519/jospt.2021.10199.
  25. Ravindra A, Barlow JD, Jones GL, Bishop JY. A prospective evaluation of predictors of pain after arthroscopic rotator cuff repair: Psychosocial factors have a stronger association than structural factors. J Shoulder Elbow Surg. 2018;27(10):1824-29. DOI: 10.1016/j.jse.2018.06.019.
  26. Gan TJ. Poorly controlled postoperative pain: Prevalence, consequences, and prevention. J Pain Res. 2017;10:2287-98. DOI: 10.2147/JPR.S144066.
  27. Panattoni N, Longo UG, De Salvatore S, Castaneda NSC, Risi Ambrogioni L, Piredda M, et al. The influence of psychosocial factors on patient-reported outcome measures in rotator cuff tears pre-and post-surgery: A systematic review. Qual Life Res. 2022;31(1):91-116. DOI: 10.1007/s11136-021-02921-2.
  28. Cole BJ, Cotter EJ, Wang KC, Davey A. Patient understanding, expectations, and satisfaction regarding rotator cuff injuries and surgical management. Arthroscopy. 2017;33(8):1603-06. DOI: 10.1016/j.arthro.2017.03.004.
  29. Meehan K, Wassinger C, Roy JS, Sole G. Seven key themes in physical therapy advice for patients living with subacromial shoulder pain: A scoping review. J Orthop Sports Phys Ther. 2020;50(6):345-53. DOI: 10.2519/jospt.2020.9152.
  30. Moseley GL. Reconceptualising pain according to modern pain science. Phys Ther Rev. 2007;12(3):169-78. DOI: 10.1179/108331907X223010
  31. Sloan TJ, Walsh DA. Explanatory and diagnostic labels and perceived prognosis in chronic low back pain. Spine. 2010;35(21):E1120-E1125. DOI: 10.1097/BRS.0b013e3181e089a9.
  32. Vlaeyen JW, Crombez G, Linton SJ. The fear-avoidance model of pain. Pain. 2016;157(8):1588-89. DOI: 10.1097/j.pain.0000000000000574.
  33. Wood L, Hendrick PA. A systematic review and meta-analysis of pain neuroscience education for chronic low back pain: Short- and long-term outcomes of pain and disability. Eur J Pain. 2019;23(2):234-49. DOI: 10.1002/ejp.1314.
  34. Nijs J, Paul van Wilgen C, Van Oosterwijck J, van Ittersum M, Meeus M. How to explain central sensitization to patients with 'unexplained' chronic musculoskeletal pain: Practice guidelines. Man Ther. 2011;16(5):413-18. DOI: 10.1016/j.math.2011.04.005.
  35. Watson JA, Ryan CG, Cooper L, Ellington D, Whittle R, Lavender M, et al. Pain neuroscience education for adults with chronic musculoskeletal pain: A mixed-methods systematic review and meta-analysis. J Pain. 2019;20(10):1140-e1. DOI: 10.1016/j.jpain.2019.02.011.
  36. Huysmans E, Baeyens JP, Dueñas L, Falla D, Meeus M, Roose E, et al. Do sex and pain characteristics influence the effectiveness of pain neuroscience education in people scheduled for total knee arthroplasty? secondary analysis of a randomized controlled trial. Phys Ther. 2021;101(12):pzab197. DOI: 10.1093/ptj/pzab197.
  37. Núñez-Cortés R, Espinoza-Ordóñez C, Pommer PP, Horment-Lara G, Pérez-Alenda S, Cruz-Montecinos C. A single preoperative pain neuroscience education: Is it an effective strategy for patients with carpal tunnel syndrome? Med Hypotheses. 2019 May;126:46-50. DOI: 10.1016/j.mehy.2019.03.013.
  38. Ezzo J, Berman B, Hadhazy VA, Jadad AR, Lao L, Singh BB. Is acupuncture effective for the treatment of chronic pain? A systematic review. Pain. 2000 Jun;86(3):217-25. DOI: 10.1016/S0304-3959(99)00304-8.
  39. Fernández-de-Las-Peñas C, Alonso-Blanco C, Cuadrado ML, Miangolarra JC, Barriga FJ, Pareja JA. Are manual therapies effective in reducing pain from tension-type headache? A systematic review. Clin J Pain. 2006;22(3):278-85. DOI: 10.1097/01.ajp.0000173017.64741.86.
  40. Louw A, Puentedura EJ, Zimney K, Schmidt S. Know Pain, Know Gain? A perspective on pain neuroscience education in physical therapy. J Orthop Sports Phys Ther. 2016;46(3):131-34. DOI: 10.2519/jospt.2016.0602.
  41. Sawyer EE, McDevitt AW, Louw A, Puentedura EJ, Mintken PE. Use of pain neuroscience education, tactile discrimination, and graded motor imagery in an individual with frozen shoulder. J Orthop Sports Phys Ther. 2018;48(3):174-84. DOI: 10.2519/jospt.2018.7716.
  42. Acker R, Swain N, Perry M, Wassinger C, Sole G. Thinking about pain in a different way: Patient perspectives of a neuroscience-informed physiotherapy programme for rotator cuff-related shoulder pain. Musculoskelet Sci Pract. 2023;63:102691. DOI: 10.1016/j.msksp.2022.102691.
  43. Louw A, Rico D, Langerwerf L, Maiers N, Diener I, Cox T. Preoperative pain neuroscience education for shoulder surgery: A case series. S Afr J Physiother. 2020;76(1):141. DOI: 10.4102/sajp.v76i1.1417.
  44. de Morton NA. The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study. Aust J Physiother. 2009;55(2):129-33. DOI: 10.1016/s0004-9514(09)70043-1.
  45. Maher CG, Sherrington C, Herbert RD, Moseley AM, Elkins M. Reliability of the PEDro scale for rating quality of randomized controlled trials. Phys Ther. 2003 Aug;83(8):713-21.
  46. Maher CG. A systematic review of workplace interventions to prevent low back pain. Aust J Physiother. 2000;46(4):259-269. DOI: 10.1016/s0004-9514(14)60287-7.