A Modern Neuroscience Approach to Chronic Spinal Pain: Combining Pain Neuroscience Education With Cognition-Targeted Motor Control Training
Abstract
Chronic spinal pain (CSP) is a severely disabling disorder, including nontraumatic 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 such as 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 (ie, hyperexcitability of the central nervous system and brain abnormalities) play a role in CSP. Hence, treatments for CSP should address not only peripheral dysfunctions but also the brain. Therefore, a modern neuroscience approach, comprising therapeutic pain neuroscience education followed by cognition-targeted motor control training, is proposed. This perspective article explains why and how such an approach to CSP can be applied in physical therapist practice.
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This form of pain education was developed in Australia and has been adapted in numerous Western countries, demonstrating mixed results for effectiveness for managing LBP.
“This form of pain education (widely known as ‘Explain Pain’ or ‘Pain Neuroscience Education’)15–24 was developed in Australia and has been adapted in numerous Western countries, demonstrating mixed results for effectiveness for managing LBP.15 17 21 23–25”
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- Authors
- Nijs, J., Meeus, M., Cagnie, B., Roussel, N. A., Dolphens, M., Van Oosterwijck, J., & Danneels, L.
- Affiliations
- Vrije Universiteit Brussel (BE)
- University of Antwerp (BE)
- Ghent University (BE)
- J. Van Oosterwijck, PT, PhD, Pain in Motion Research Group, Departments of Human Physiology and Physiotherapy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, and Department of Rehabilitation Sciences and Physiotherapy, Ghent University.
- Corresponding author
- Nijs, Jo
- Venue
- Physical Therapy
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-05-01
- Volume
- 94
- Issue
- 5
- Pages
- 730-738
- ISSN
- 0031-9023 (ISSN-L)
- 1538-6724
- OpenAlex
- W2133202890
- Cited by
- 190
- References
- 82
- Citations by year
- 2026: 11 · 2025: 17 · 2024: 12 · 2023: 12 · 2022: 11 · 2021: 24 · 2020: 16 · 2019: 26 · 2018: 15 · 2017: 18 · 2016: 9 · 2015: 13 · 2014: 6
- FWCI
- 11.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Physical Therapy (publishedVersion)
- PubMed (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Keywords
- chronic spinal pain, pain neuroscience education, motor control training, central sensitization, central nervous system hyperexcitability, chronic low back pain, chronic neck pain, whiplash-associated disorders, failed back surgery syndrome, cognitive training
- MeSH terms
- Atrophy, Brain, Communication, Exercise Therapy, Humans, Movement, Neurosciences, Patient Education as Topic, Posture, Whiplash Injuries, Low Back Pain, Muscle, Skeletal, Patient Selection, Neck Pain, Physical Therapy Modalities, Failed Back Surgery Syndrome, Chronic Pain
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