Combining Pain Neuroscience Education With Cognition-Targeted Motor Control Training
Nijs J, et al. Show all Journal
Phys Ther. 2014 Jan 30. [Epub ahead of print]
Abstract
Chronic spinal pain (CSP) is a severely disabling disorder, including non-traumatic chronic low back and neck pain, failed back surgery and chronic whiplash associated disorders. Much of the current therapy is focused on input mechanisms (treating peripheral elements like muscles and joints) and output mechanisms (addressing motor control), while there is less attention to processing (central) mechanisms. In addition to the compelling evidence for impaired motor control of spinal muscles in patients with CSP, there is increasing evidence that central mechanisms, i.e. hyperexcitability of the central nervous system and brain abnormalities play a role in CSP. Hence, treatments for CSP should not only address peripheral dysfunctions, but also the brain. Therefore, a modern neuroscience approach, comprising of therapeutic pain neuroscience education followed by cognition-targeted motor control training, is proposed. This perspective paper explains why and how such an approach to CSP can be applied in physical therapy practice.