Pain neuroscience education as a therapeutic strategy in the management of chronic pelvic pain associated with endometriosis: an integrative review

Abstract

Endometriosis is a chronic inflammatory condition frequently associated with chronic pelvic pain, whose complexity involves not only peripheral alterations but also central mechanisms, such as central sensitization. In this context, Pain Neuroscience Education (PNE) has been proposed as a therapeutic strategy aimed at modulating pain through the understanding of its neurophysiological mechanisms. This study aimed to analyze the scientific evidence regarding the application of PNE in the management of chronic pelvic pain associated with endometriosis. This is an integrative literature review conducted using the PubMed database, covering studies published between 2016 and 2026, using descriptors related to endometriosis, chronic pelvic pain, central sensitization, and pain education. Clinical trials, systematic reviews, and observational studies addressing educational interventions or neurophysiological mechanisms of pain were included. A total of 10 studies were selected for analysis. The findings demonstrated that PNE has positive effects on pain reduction, functional improvement, and modulation of psychosocial factors, especially when combined with physiotherapeutic interventions such as therapeutic exercise. However, most of the available evidence is concentrated on musculoskeletal conditions, with limited direct application to endometriosis. Nevertheless, the similarity in pathophysiological mechanisms, particularly central sensitization, suggests the potential applicability of PNE in this population. It is concluded that Pain Neuroscience Education is a promising approach for managing chronic pelvic pain associated with endometriosis, especially when integrated into a biopsychosocial model of care. Further clinical studies are needed to strengthen the evidence and support clinical practice.