Study Highlights Neuroscience Education, Resistance Training in Women With Fibromyalgia

A combined program of pain neuroscience education and resistance training is shown to be more effective than aerobic and flexibility exercises in lowering short-term pain intensity in females with fibromyalgia, according to new data.1

The new research which led to these findings was authored by such investigators as Álvaro-José Rodríguez-Domínguez, PhD, from the department of health and sports at Pablo de Olavide University in Seville, Spain. Rodríguez-Domínguez and coauthors sought to compare a combined program with pain neuroscience education alongside resistance training, which they called ‘PNE + RT,’ with a combined aerobic and flexibility exercise program, labeled ‘AE + FE.’

The investigators highlighted that advances in neuroscience led to a novel treatment method called pain neuroscience education (PNE). They pointed to systematic review data, along with meta-analyses, that have previously demonstrated the value of such an intervention.2

“Therefore, the objective of this study was to evaluate the effects of PNE in combination with RT...compared to the AE combined with FE...and to continue with the usual medication,” Rodríguez-Domínguez and colleagues wrote.1 “Hence, this study has an exploratory character, as it compares two different intervention protocols.”

Trial and Notable Findings

The aim of Rodríguez-Domínguez et al was to look into the impact of combining pain neuroscience education with resistance training (PNE + RT) versus a combination of aerobic exercise with flexibility exercises (AE + FE). During this process, the women assessed would continue standard pharmacological treatment for their fibromyalgia.

This randomized pilot trial was conducted at a single center and made using a prospective, controlled study design with evaluator blinding. Those who were deemed to be eligible as participants were women diagnosed with fibromyalgia who were also in the age range of 20 - 65 years. These subjects' diagnoses specifically would have been done by a rheumatologist based on American College of Rheumatology criteria, with symptom duration exceeding a single year and adequate cognitive capacity required by investigators for these individuals to follow the trial's instructions.

There were 31 women in total who were randomly placed in either the PNE + RT cohort or the AE + FE cohort, with 15 and 16 in these groups, respectively. Both interventions were performed 3 times per week over the course of a 12-week period. Rodríguez-Domínguez and colleagues included among their primary outcomes measures of pain intensity, disability, and symptoms associated with central sensitization. They designated pain intensity as the principal outcome for the purposes of their statistical analysis.

In terms of secondary outcomes, the investigative team evaluated maximum handgrip strength (MHS), pressure pain threshold (PPT), and perceived stiffness. In their between-group comparisons, the team found statistically significant advantages for the PNE + RT arm of their analysis in terms of reduction in short-term pain intensity (P < .05) and increased PPT in the trapezius muscle (P < .05).1

Rodríguez-Domínguez and coauthors concluded, in their within-group analysis for the PNE + RT cohort, that significant improvements in participants' central sensitization symptoms (P < .01), intensity of pain (P < .01), quadriceps PPT (P < 0.01), and left-hand MHS (P < .01) were noted. Both of their study's cohorts were noted as having significantly improved in their disability scores (P < .01), although neither arm of the study showed significant stiffness changes.

In summary, Rodríguez-Domínguez et al found that superior efficacy among those given the PNE + RT intervention was demonstrated over the AE + FE group, specifically in terms of reducing short-term pain in subjects and increasing trapezius PPT. The AE + FE intervention led only to significant improvements in disability. Such early data would indicate a broad range of benefits by PNE + RT, potentially.

"The AE + FE program is only effective in improving disability," the investigators wrote.1 "More RCTs are needed to corroborate these findings."

References

1. Rodríguez-Domínguez, Álvaro-José, José-Jesús, et al. Pain Neuroscience Education and Resistance Training in Women With Fibromyalgia: A Randomized Control Pilot Study, Pain Research and Management, 2025, 7550108, 14 pages, 2025. https://doi.org/10.1155/prm/7550108.

2. Saracoglu I, Akin E, Aydin Dincer GB. Efficacy of Adding Pain Neuroscience Education to a Multimodal Treatment in Fibromyalgia: A Systematic Review and Meta-Analysis, International Journal of Rheumatic Diseases. (2022) 25, no. 4, 394–404, https://doi.org/10.1111/1756-185X.14293.