Efficacy of pain neuroscience education compared to conventional therapy in managing oncologic pain: A controlled clinical trial

Background: Pain is a multifaceted sensory and emotional experience that may arise even without evident tissue injury. Among individuals undergoing cancer treatment, it represents one of the most prevalent and burdensome symptoms, frequently resulting from surgical interventions, radiotherapy, or treatment-related toxicity. Oncologic pain profoundly impacts functional capacity, emotional well-being, and overall quality of life. Given its multidimensional nature, it involves complex interactions between cognitive, affective, and neurophysiological mechanisms, including processes of central sensitization and altered pain modulation. These complexities highlight the need for integrative approaches that move beyond traditional biomedical management. Educational strategies such as Pain Neuroscience Education (PNE) have emerged as promising interventions aimed at reshaping maladaptive pain beliefs, reducing fear and catastrophizing, and fostering more effective self-management. In this context, the present study aimed to determine the efficacy of Pain Neuroscience Education compared to conventional therapy in managing oncologic pain. Methods: A randomized controlled clinical trial with a parallel-group design and blinded outcome assessment was performed following the CONSORT recommendations (ClinicalTrials.gov ID: NCT05581784). The intervention comprised a structured nine-session program centered on the application of neuroscience principles to pain education, based on a previously published manual. All outcome measures were collected after a 10-week period. The primary endpoint was the variation in pain intensity, assessed using the Visual Analog Scale (VAS), comparing baseline and post-intervention scores between groups. Results: A total of eighty-two patients with oncologic pain were included in the study. The most common cancer diagnosis was breast cancer. Regarding disease stage, 63% of participants were classified as stage III, 31.8% as stage IV, and 4.5% as stage V. In the intervention group (PNE), mean pain intensity decreased from 5.32 ± 2.12 at baseline (T1) to 3.85 ± 1.98 after the intervention (T2), reflecting a statistically significant reduction of 1.47 points (p < 0.001). Conversely, in the control group, pain intensity values were 5.57 ± 2.29 at T1 and 5.39 ± 2.15 at T2, showing no significant change (p = 0.46). The reduction in pain intensity observed in the PNE group represents a clinically meaningful improvement compared with the control condition. Conclusion: The intervention grounded in Pain Neuroscience Education (PNE) led to a statistically and clinically meaningful decrease in pain intensity. These findings support the inclusion of individualized educational approaches as a complementary component of oncologic pain management.