Chronic spinal pain (CSP) is a large problem in the western world

Chronic spinal pain (CSP) is a large problem in the western world. Most of the current treatments are focusing on input mechanism (peripheral elements like muscles/joints) and output mechanism (motor control) of pain. There is an increasing evidence that patients with CSP have altered central mechanisms like central sensitization and brain abnormalities. This paper presents an approach with more focus on central (processing) mechanisms. 

The approach suggested is divided in three phases and focuses on both therapeutic pain neuroscience education and cognition-targeted motor control training. Phase 1 focuses on therapeutic pain neuroscience education. Phase 2 started once the patient has adopted adaptive beliefs regarding CSP. This phase includes exercise therapy with specific emphasis on spine motor control training. The last phase focuses on dynamic and functional exercise to make a transfer to daily life activities. > From: Nijs et al., Phys Ther (2014) (Epub ahead of print). All rights reserved to the American Physical Therapy Association.