This article will introduce a conceptual framework of kinesthetic education that is consistent with and reinforces pain neuroscience education. This article will also provide some specific guidance for integrating pain neuroscience education with exercise and movement in a more congruent manner. Our belief is that this will enhance the effectiveness of specific movement approaches such as graded exposure techniques. Over the past decade, a new paradigm of pain education has been explored in an effort to improve patient outcomes. Using advances in pain neuroscience, patients are educated in the biological and physiological processes involved in their pain experience. Growing evidence supports the ability of pain neuroscience education (PNE) to positively impact a person's pain ratings, disability, pain catastrophization, and movement limitations. What is often overlooked, however, is the consistency between the messages of PNE and those of other therapeutic interventions, including movement therapies. This article proposes the following: education provided in isolation will be limited in its impact, the addition of guided purposeful movement performed in a manner consistent with PNE may be vital to the desired behavioral changes, and when inconsistent messages are delivered between education and movement interventions, outcomes may be adversely impacted.

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Therapist as 'contextual architect' I would like to thank Bialosky et al. for their excellent article clarifying and discussing how and why to maximize placebo in manual therapy 1 practice. I would like to consider here the implications that placebo, conditioning, and expectation have on our roles and responsibilities as manual therapists.