{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:13:08Z","timestamp":1787238788502,"version":"build-2736575974"},"reference-count":36,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Musculoskeletal Science and Practice"],"published-print":{"date-parts":[[2026,2]]},"DOI":"10.1016\/j.msksp.2025.103476","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T16:43:06Z","timestamp":1766594586000},"page":"103476","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":2,"special_numbering":"C","title":["The pain education paradox and validation gap"],"prefix":"10.1016","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4174-7149","authenticated-orcid":false,"given":"Asaf","family":"Weisman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Noy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youssef","family":"Masharawi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"5","key":"10.1016\/j.msksp.2025.103476_bib1","doi-asserted-by":"crossref","first-page":"1787","DOI":"10.1096\/fj.201601326R","article-title":"It's time to redefine inflammation","volume":"31","author":"Antonelli","year":"2017","journal-title":"FASEB"},{"issue":"1","key":"10.1016\/j.msksp.2025.103476_bib2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/24740527.2021.2004103","article-title":"Development of a national pain management competency profile to guide entry-level physiotherapy education in Canada","volume":"6","author":"Augeard","year":"2022","journal-title":"Can J Pain"},{"issue":"6","key":"10.1016\/j.msksp.2025.103476_bib3","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/S1474-4422(14)70024-9","article-title":"Painful and painless channelopathies","volume":"13","author":"Bennett","year":"2014","journal-title":"Lancet Neurol."},{"key":"10.1016\/j.msksp.2025.103476_bib4","doi-asserted-by":"crossref","DOI":"10.1016\/j.jpain.2024.104738","article-title":"Language errors in pain medicine: an umbrella review","volume":"28","author":"B\u00e9raud","year":"2025","journal-title":"J. Pain"},{"issue":"8","key":"10.1016\/j.msksp.2025.103476_bib5","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1016\/j.ejpain.2011.01.006","article-title":"Survey of undergraduate pain curricula for healthcare professionals in the United Kingdom","volume":"15","author":"Briggs","year":"2011","journal-title":"Eur. J. Pain"},{"issue":"8","key":"10.1016\/j.msksp.2025.103476_bib6","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1016\/j.jpain.2013.02.008","article-title":"How good is the neurophysiology of pain questionnaire? A rasch analysis of psychometric properties","volume":"14","author":"Catley","year":"2013","journal-title":"J. Pain"},{"issue":"2","key":"10.1016\/j.msksp.2025.103476_bib7","article-title":"Reconsidering the international association for the study of pain definition of pain","volume":"3","author":"Cohen","year":"2018","journal-title":"Pain Rep"},{"issue":"12","key":"10.1016\/j.msksp.2025.103476_bib8","doi-asserted-by":"crossref","first-page":"2131","DOI":"10.1016\/j.jpain.2023.07.019","article-title":"\u201cNociplastic pain\u201d: a challenge to nosology and to nociception","volume":"24","author":"Cohen","year":"2023","journal-title":"J. Pain"},{"issue":"8","key":"10.1016\/j.msksp.2025.103476_bib9","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1016\/j.jpain.2022.03.235","article-title":"Pain is not a \u201cthing\u201d: how that error affects language and logic in pain medicine","volume":"23","author":"Cohen","year":"2022","journal-title":"J. Pain"},{"issue":"10289","key":"10.1016\/j.msksp.2025.103476_bib10","doi-asserted-by":"crossref","first-page":"2082","DOI":"10.1016\/S0140-6736(21)00393-7","article-title":"Chronic pain: an update on burden, best practices, and new advances","volume":"397","author":"Cohen","year":"2021","journal-title":"Lancet"},{"issue":"9\u201310","key":"10.1016\/j.msksp.2025.103476_bib11","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1089\/neu.2022.0238","article-title":"Major differences in transcriptional alterations in dorsal root ganglia between spinal cord injury and peripheral neuropathic pain models","volume":"40","author":"Cuevas-Diaz Duran","year":"2023","journal-title":"J. Neurotrauma"},{"issue":"7","key":"10.1016\/j.msksp.2025.103476_bib12","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1111\/pme.12107","article-title":"Core competencies for pain management: results of an interprofessional consensus summit","volume":"14","author":"Fishman","year":"2013","journal-title":"Pain Med."},{"issue":"1","key":"10.1016\/j.msksp.2025.103476_bib13","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/s12998-018-0212-0","article-title":"Changes in pain knowledge, attitudes and beliefs of osteopathy students after completing a clinically focused pain education module","volume":"26","author":"Fitzgerald","year":"2018","journal-title":"Chiropr. Man. Ther."},{"key":"10.1016\/j.msksp.2025.103476_bib14","series-title":"Canadian Pain Task Force Report: March 2021","author":"Force","year":"2021"},{"key":"10.1016\/j.msksp.2025.103476_bib15","doi-asserted-by":"crossref","DOI":"10.1016\/j.intimp.2022.108700","article-title":"The contribution of neuro-immune crosstalk to pain in the peripheral nervous system and the spinal cord","volume":"107","author":"Gao","year":"2022","journal-title":"Int. Immunopharmacol."},{"issue":"3","key":"10.1016\/j.msksp.2025.103476_bib16","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1016\/j.jpain.2021.09.002","article-title":"Development and initial evaluation of psychometric properties of a pain competence assessment tool (PCAT)","volume":"23","author":"Hassan","year":"2022","journal-title":"J. Pain"},{"issue":"1","key":"10.1016\/j.msksp.2025.103476_bib17","doi-asserted-by":"crossref","first-page":"29","DOI":"10.3109\/15360288.2010.547560","article-title":"Declaration of Montr\u00e9al: declaration that access to pain management is a fundamental human right","volume":"25","year":"2011","journal-title":"J. Pain Palliat. Care Pharmacother."},{"issue":"5","key":"10.1016\/j.msksp.2025.103476_bib20","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1097\/j.pain.0000000000002436","article-title":"Effectiveness of training physical therapists in pain neuroscience education for patients with chronic spine pain: a cluster-randomized trial","volume":"163","author":"Lane","year":"2022","journal-title":"Pain"},{"issue":"2","key":"10.1016\/j.msksp.2025.103476_bib21","doi-asserted-by":"crossref","first-page":"57","DOI":"10.2519\/jospt.2021.9804","article-title":"Revisiting the provision of pain neuroscience education: an adjunct intervention for patients but a primary focus of clinician education","volume":"51","author":"Louw","year":"2020","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"10.1016\/j.msksp.2025.103476_bib22","doi-asserted-by":"crossref","first-page":"270","DOI":"10.3389\/fnins.2020.00270","article-title":"Walking the tightrope: a proposed model of chronic pain and stress","volume":"14","author":"Lunde","year":"2020","journal-title":"Front. Neurosci."},{"key":"10.1016\/j.msksp.2025.103476_bib23","doi-asserted-by":"crossref","DOI":"10.3389\/fphar.2021.649807","article-title":"Purines in pain as a gliopathy","volume":"12","author":"Magni","year":"2021","journal-title":"Front. Pharmacol."},{"key":"10.1016\/j.msksp.2025.103476_bib24","first-page":"1","article-title":"Fibromyalgia: a satellite gliopathy","volume":"43","author":"Mercado","year":"2024","journal-title":"Clin. Exp. Rheumatol."},{"issue":"2","key":"10.1016\/j.msksp.2025.103476_bib25","doi-asserted-by":"crossref","first-page":"e273","DOI":"10.1016\/j.bja.2019.03.023","article-title":"Chronic pain: a review of its epidemiology and associated factors in population-based studies","volume":"123","author":"Mills","year":"2019","journal-title":"Br. J. Anaesth."},{"key":"10.1016\/j.msksp.2025.103476_bib26","series-title":"Explain Pain Supercharged: the Clinician's Manual","author":"Moseley","year":"2017"},{"issue":"3","key":"10.1016\/j.msksp.2025.103476_bib27","doi-asserted-by":"crossref","DOI":"10.1016\/j.jbspin.2025.105999","article-title":"Immune control of pain","volume":"93","author":"Paolini","year":"2025","journal-title":"Jt. Bone Spine"},{"issue":"9","key":"10.1016\/j.msksp.2025.103476_bib28","doi-asserted-by":"crossref","first-page":"1976","DOI":"10.1097\/j.pain.0000000000001939","article-title":"The revised international association for the study of pain definition of pain: concepts, challenges, and compromises","volume":"161","author":"Raja","year":"2020","journal-title":"Pain"},{"issue":"4","key":"10.1016\/j.msksp.2025.103476_bib29","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1097\/j.pain.0000000000000454","article-title":"Pain and the global burden of disease","volume":"157","author":"Rice","year":"2016","journal-title":"Pain"},{"issue":"6","key":"10.1016\/j.msksp.2025.103476_bib30","article-title":"Why might fears and worries persist after a pain education\u2013grounded multimodal intervention for chronic back pain? A qualitative study","volume":"9","author":"Rizzo","year":"2024","journal-title":"Pain Rep"},{"issue":"2","key":"10.1016\/j.msksp.2025.103476_bib31","doi-asserted-by":"crossref","DOI":"10.1002\/pri.1898","article-title":"Does pain neuroscience education improve pain knowledge, beliefs and attitudes in undergraduate physiotherapy students?","volume":"26","author":"Saracoglu","year":"2021","journal-title":"Physiother. Res. Int."},{"issue":"11","key":"10.1016\/j.msksp.2025.103476_bib32","doi-asserted-by":"crossref","first-page":"pzac109","DOI":"10.1093\/ptj\/pzac109","article-title":"Empowering physical therapist professional education programs to deliver modern pain content","volume":"102","author":"Shepherd","year":"2022","journal-title":"Phys. Ther."},{"issue":"6","key":"10.1016\/j.msksp.2025.103476_bib33","doi-asserted-by":"crossref","first-page":"pzae036","DOI":"10.1093\/ptj\/pzae036","article-title":"Orthopaedic manual physical therapy: a modern definition and description","volume":"104","author":"Silvernail","year":"2024","journal-title":"Phys. Ther."},{"issue":"10","key":"10.1016\/j.msksp.2025.103476_bib34","doi-asserted-by":"crossref","first-page":"1140","DOI":"10.1016\/j.jpain.2019.02.011","article-title":"Pain neuroscience education for adults with chronic musculoskeletal pain: a mixed-methods systematic review and meta-analysis","volume":"20","author":"Watson","year":"2019","journal-title":"J. Pain"},{"key":"10.1016\/j.msksp.2025.103476_bib35","doi-asserted-by":"crossref","DOI":"10.1016\/j.mehy.2025.111633","article-title":"Anesthetic insights from sham surgeries: is the future of chronic pain relief hidden in our controls?","volume":"198","author":"Weisman","year":"2025","journal-title":"Med. Hypotheses"},{"key":"10.1016\/j.msksp.2025.103476_bib36","article-title":"Attitudinal responses to current concepts and opinions from pain neuroscience education on social media","volume":"59","author":"Weisman","year":"2022","journal-title":"Musculoskelet Sci Pract"},{"key":"10.1016\/j.msksp.2025.103476_bib37","doi-asserted-by":"crossref","DOI":"10.7717\/peerj.19448","article-title":"Education about pain and experience with cognitive-based interventions do not reduce healthcare professionals' chronic pain","volume":"13","author":"Weisman","year":"2025","journal-title":"PeerJ"},{"issue":"2","key":"10.1016\/j.msksp.2025.103476_bib38","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1002\/ejp.1314","article-title":"A systematic review and meta-analysis of pain neuroscience education for chronic low back pain: short-And long-term outcomes of pain and disability","volume":"23","author":"Wood","year":"2019","journal-title":"Eur. J. Pain"}],"container-title":["Musculoskeletal Science and Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2468781225002243?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2468781225002243?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:47:49Z","timestamp":1767746869000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2468781225002243"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":36,"alternative-id":["S2468781225002243"],"URL":"https:\/\/doi.org\/10.1016\/j.msksp.2025.103476","relation":{},"ISSN":["2468-7812"],"issn-type":[{"value":"2468-7812","type":"print"}],"subject":[],"published":{"date-parts":[[2026,2]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"The pain education paradox and validation gap","name":"articletitle","label":"Article Title"},{"value":"Musculoskeletal Science and Practice","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.msksp.2025.103476","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"103476"}}