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•Large trial studying a contemporary neuroscience therapy for chronic whiplash.•Trial integrating stress management in the neuroscience approach for whiplash.•Assess if a contemporary neuroscience therapy can decrease central sensitization.•This trial may provide new improved treatment guidelines for chronic whiplash.•This trial may be used as a basis for recommendations to health authorities.

Pain neuroscience education (PNE) and motivational interviewing (MI) have been widely implemented and tested in the field of chronic pain management, and both strategies have been shown to be effective in the short term (small effect sizes) for the management of chronic pain. PNE uses contemporary pain science to educate patients about the biopsychosocial nature of the chronicity of their pain experience. The goal of PNE is to optimize patients’ pain beliefs/perceptions to facilitate the acquisition of adaptive pain–coping strategies. MI, on the other hand, is a patient-centered communication style for eliciting and enhancing motivation for behavior change by shifting the patient away from a state of indecision or uncertainty. Conceptually, PNE and MI appear to be complementary interventions, with complementary rather than overlapping effects; MI primarily improves cognitive and behavioral awareness and, potentially, adherence to treatment principles, whereas PNE potentially increases pain knowledge/beliefs, awareness, and willingness to explore psychological factors that are potentially associated with pain. Therefore, combining PNE with MI might lead to improved outcomes with larger and longer-lasting effect sizes. The combined use of PNE and MI in patients having chronic pain is introduced here, along with a description of how clinicians might be able to integrate PNE and MI in the treatment of patients experiencing chronic pain. Clinical trials are needed to examine whether combining PNE with MI is superior to PNE or MI alone for improving pain and quality of life in patients having chronic pain.

•Explaining pain to patients who survived cancer should be individually tailored.•Take the patient's pain beliefs, cognitions, pain memories, social factors and dominant pain mechanism into account.•Explaining pain implies teaching patients about the underlying biopsychosocial mechanisms of pain.•Pain neuroscience education is a potential solution to improve pain outcome in cancer survivors, but should never be a stand-alone treatment.•Pain neuroscience education should precede interventions such as graded activity, exercise therapy, stress management, sleep management and dietary advice.

•The amount of moderate-to-vigorous physical activity (MVPA) varies across individuals with nonspecific chronic spinal pain (nCSP) and comorbid insomnia.•Sleep quality, limitations in functioning, body mass index, and fatigue predict MVPA.•No determinants for a change in MVPA after physical therapy were identified.•The change of MVPA in response to physical therapy varied across participants.

Individuals classified as having whiplash-associated disorder (WAD) grade II, which reflects approximately 93% of people with WAD who are commonly managed by health care professionals, exhibit both physical (eg, pain and disability) and psychological (eg, fear of movement, anxiety, posttraumatic stress) problems that, in approximately 50% of cases, persist beyond 3 months. There is still much ongoing debate regarding factors predictive of poor recovery. The strongest associations have been found for high initial pain and disability following whiplash injury. In addition, a growing body of evidence supports the clinical importance of characteristic features, such as disturbed nociceptive processing (eg, local or general hyperalgesia to cold and mechanical stimuli), inefficient cognitions and beliefs about pain/movement/recovery, and posttraumatic stress symptoms, in the development and maintenance of physical and psychological manifestations in individuals with WAD. For this reason, the field shifted away from single interventions that mainly follow a biomedical approach, such as exercise therapy and activity programs, to gold standard multimodal care (at least 2 distinct therapeutic modalities given by 1 or more health care professionals) that acknowledges the biopsychological nature of WAD. To date, there exist several multimodal care approaches to managing WAD; however, for most, the efficacy has been found to be rather limited. One may argue that the limited success of some approaches can be attributed to the fact that they focused mainly on rehabilitating the physical symptoms (eg, pain, disability) rather than also the associated cognitive (eg, catastrophizing) and psychological (eg, posttraumatic stress symptoms) symptoms of the condition, leaving much room for improvement. In this article, current and previous evidence is used to explain why and how a comprehensive and multimodal treatment for people with WAD—consisting of a combination of pain neuroscience education, cognition-targeted exercise therapy, and stress management—can be applied in clinical practice.