{"id":1593,"date":"2015-05-18T13:03:37","date_gmt":"2015-05-18T13:03:37","guid":{"rendered":"https:\/\/andreasphysioblog.com\/?p=1593"},"modified":"2021-05-01T13:06:39","modified_gmt":"2021-05-01T13:06:39","slug":"a-modern-neuroscience-approach-to-chronic-spinal-pain-combining-pain-neuroscience-education-with-cognition-targeted-motor-control-training","status":"publish","type":"post","link":"https:\/\/andreasphysioblog.com\/?p=1593","title":{"rendered":"A Modern Neuroscience Approach to Chronic Spinal Pain: Combining Pain Neuroscience Education With Cognition-Targeted Motor Control Training"},"content":{"rendered":"<p><strong>A Modern Neuroscience Approach to Chronic Spinal Pain: Combining Pain<\/strong><strong>Neuroscience Education With Cognition-Targeted Motor Control Training<\/strong> <a href=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-53-38.png\"><img decoding=\"async\" class=\"alignright wp-image-5331\" src=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-53-38.png?w=165&amp;h=156\" sizes=\"(max-width: 165px) 100vw, 165px\" srcset=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-53-38.png?w=165&amp;h=156 165w, https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-53-38.png?w=330&amp;h=312 330w, https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-53-38.png?w=150&amp;h=141 150w, https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-53-38.png?w=300&amp;h=283 300w\" alt=\"Sk\u00e6rmbillede 2015-05-18 kl. 06.53.38\" width=\"165\" height=\"156\" data-attachment-id=\"5331\" data-permalink=\"https:\/\/physioblogandreasbjerregaard.com\/2015\/05\/18\/a-modern-neuroscience-approach-to-chronic-spinal-pain-combining-pain-neuroscience-education-with-cognition-targeted-motor-control-training\/skaermbillede-2015-05-18-kl-06-53-38\/\" data-orig-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-53-38.png\" data-orig-size=\"382,360\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Sk\u00e6rmbillede 2015-05-18 kl. 06.53.38\" data-image-description=\"\" data-medium-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-53-38.png?w=300\" data-large-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-53-38.png?w=382\" \/><\/a>This blogpost is writting by a good friend and inspirering colleague in the field of physiotherapy, Alexander Hummelsh\u00f8j Kringelbach, who has summerize an article prior to a moderne neuroscience\u00a0path for chronic back pain and how it can be combined with motor Control. See the article <a href=\"http:\/\/ptjournal.apta.org\/content\/early\/2014\/01\/29\/ptj.20130258.full.pdf:\">here.<\/a><\/p>\n<p>You can get in touch with Alexander on LinkedIn through this link:\u00a0<a href=\"http:\/\/linkedin.com\/pub\/alexander-kringelbach\/65\/56a\/639\/en\">linkedin.com\/pub\/alexander-kringelbach\/65\/56a\/639\/en<\/a><\/p>\n<p>Go to my webpage for more info about treatments and rehabilitation in Copenhagen:\u00a0<strong>S\u00f8ernesFysioterapi.dk.<\/strong><\/p>\n<p><a href=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-43-05.png\"><img fetchpriority=\"high\" decoding=\"async\" class=\"alignnone wp-image-5330 \" src=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-43-05.png?w=702&amp;h=79\" sizes=\"(max-width: 702px) 100vw, 702px\" srcset=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-43-05.png?w=702&amp;h=79 702w, https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-43-05.png?w=1404&amp;h=158 1404w, https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-43-05.png?w=150&amp;h=17 150w, https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-43-05.png?w=300&amp;h=34 300w, https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-43-05.png?w=768&amp;h=86 768w, https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-43-05.png?w=1024&amp;h=115 1024w\" alt=\"Sk\u00e6rmbillede 2015-05-18 kl. 06.43.05\" width=\"702\" height=\"79\" data-attachment-id=\"5330\" data-permalink=\"https:\/\/physioblogandreasbjerregaard.com\/2015\/05\/18\/a-modern-neuroscience-approach-to-chronic-spinal-pain-combining-pain-neuroscience-education-with-cognition-targeted-motor-control-training\/skaermbillede-2015-05-18-kl-06-43-05\/\" data-orig-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-43-05.png\" data-orig-size=\"1586,178\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Sk\u00e6rmbillede 2015-05-18 kl. 06.43.05\" data-image-description=\"\" data-medium-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-43-05.png?w=300\" data-large-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-43-05.png?w=825\" \/><\/a><\/p>\n<p>Central sensitization encompasses altered sensory processing, leading to generalized hypersensitivity of the somatosensory system.<\/p>\n<p>There is compelling evidence for impaired motor control in patients with Low Back Bain (LBP) and Chronic Spinal Pain (CSP). Intriguingly, these dysfunctions do not spontaneously resolve when spinal pain dissipates and these dysfunctions are observable in patients with recurrent low back pain.<\/p>\n<p>Studies demonstrated a loss of grey matter volume in the somatosensory cortex in patients with chronic low back pain which was strongly correlated with pain duration and pain intensity.<\/p>\n<p>Therefore impaired motor control of spinal muscles in recurrent LBP and CSP implies a reversible but maladaptive brain neuroplasticity of the somatorsensory cortex. The disturbance of proprioception by impaired motor control and altered pain sensation caused by changes in central mechanisms, leading to hypersensitivity of the somatosensory system builds the foundation for chronic pain.<\/p>\n<p>A modern neuroscience approach to Chronic Spinal Pain (CSP) using a comprehensive rehabilitation program comprising of pain neuroscience education followed by cognition-targeted motor control training have recently been shown effective as sole treatments for people with Chronic Spinal Pain (CSP). This suggests a strong synergistic effect of neuroscience education and exercise therapy for spinal motor control.<\/p>\n<p>Rehabilitation of Chronic Spinal Pain (CSP) should therefore not only address the peripheral dysfunctions of spinal muscles and joints, nor should it only address the process of central sensitization and cortical re-organization (58), but combine both into an individualized treatment approach.<\/p>\n<p><strong>A 3-Phased treatment approach is suggested.<\/strong><\/p>\n<ul>\n<li><img decoding=\"async\" class=\"alignright wp-image-5332\" src=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-43-54.png?w=332&amp;h=262\" sizes=\"(max-width: 332px) 100vw, 332px\" srcset=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-43-54.png?w=332&amp;h=262 332w, https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-43-54.png?w=664&amp;h=524 664w, https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-43-54.png?w=150&amp;h=118 150w, https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-43-54.png?w=300&amp;h=237 300w\" alt=\"Sk\u00e6rmbillede 2015-05-18 kl. 06.43.54\" width=\"332\" height=\"262\" data-attachment-id=\"5332\" data-permalink=\"https:\/\/physioblogandreasbjerregaard.com\/2015\/05\/18\/a-modern-neuroscience-approach-to-chronic-spinal-pain-combining-pain-neuroscience-education-with-cognition-targeted-motor-control-training\/skaermbillede-2015-05-18-kl-06-43-54\/\" data-orig-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-43-54.png\" data-orig-size=\"1238,978\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Sk\u00e6rmbillede 2015-05-18 kl. 06.43.54\" data-image-description=\"\" data-medium-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-43-54.png?w=300\" data-large-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-43-54.png?w=825\" \/>Phase 1: Therapeutic Pain Neuroscience Education Challenge and change pain beliefs \u2013 reconceptualize pain sensation \u2013 reduce central nervous system hyperexcitability.<\/li>\n<li>Phase 2: Cognition-Targeted Neuromuscular Training Introduce movements using motor imagery following the principles of motor learning \u2013 progress into sensorimotor control training \u2013 it is mandatory that motor control training is cognition-targeted and seeks to normalize proprioception and pain sensation.<\/li>\n<li>Phase 3: Cognition-Targeted Dynamic and Functional Exercises Exercises to normalize function targeting coordination and improvement of posture and movement patterns with emphasis on the maintenance of optimal trunk stability and flexibility.<\/li>\n<\/ul>\n<p>Reference<\/p>\n<p><a href=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-41-55.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-5329 \" src=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-41-55.png?w=376&amp;h=129\" sizes=\"(max-width: 376px) 100vw, 376px\" srcset=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-41-55.png?w=374&amp;h=129 374w, https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-41-55.png?w=748&amp;h=258 748w, https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-41-55.png?w=150&amp;h=52 150w, https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-41-55.png?w=300&amp;h=103 300w\" alt=\"Sk\u00e6rmbillede 2015-05-18 kl. 06.41.55\" width=\"376\" height=\"129\" data-attachment-id=\"5329\" data-permalink=\"https:\/\/physioblogandreasbjerregaard.com\/2015\/05\/18\/a-modern-neuroscience-approach-to-chronic-spinal-pain-combining-pain-neuroscience-education-with-cognition-targeted-motor-control-training\/skaermbillede-2015-05-18-kl-06-41-55\/\" data-orig-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-41-55.png\" data-orig-size=\"812,280\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Sk\u00e6rmbillede 2015-05-18 kl. 06.41.55\" data-image-description=\"\" data-medium-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-41-55.png?w=300\" data-large-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2015\/05\/skc3a6rmbillede-2015-05-18-kl-06-41-55.png?w=812\" \/><\/a><\/p>\n<p>Read other related blogpost.<\/p>\n<ul>\n<li><a href=\"https:\/\/andreasbjerregaard.wordpress.com\/2014\/12\/06\/praesentation-af-et-case-studie-af-lorimor-moseley-2005-smerte-pain\/\">Pr\u00e6sentation af et Case-studie af Lorimor Moseley, 2005:<strong><em>\u00a0<\/em><\/strong><strong><em>Widespread brain activity during an abdominal task<\/em><br \/>\n<em>markedly reduced after pain physiology education: fMRI\u00a0<\/em><em>evaluation of a single patient with chronic low back pain<\/em><\/strong><br \/>\n<\/a><\/li>\n<li><a href=\"https:\/\/andreasbjerregaard.wordpress.com\/2014\/08\/29\/smertekursus-ved-soernes-fysioterapi-af-simon-kirkegaard-lars-avemarie\/\" rel=\"bookmark\">Smertekursus ved S\u00f8ernes Fysioterapi af Simon Kirkegaard &amp; Lars\u00a0Avemarie<\/a><\/li>\n<li><a href=\"https:\/\/andreasbjerregaard.wordpress.com\/2014\/08\/01\/smertelindrende-medicin-virker-ikke-pa-rygpatienter\/\" rel=\"bookmark\">Smertelindrende medicin virker ikke p\u00e5\u00a0rygpatienter<\/a><\/li>\n<li><a href=\"https:\/\/andreasbjerregaard.wordpress.com\/2015\/02\/21\/reflektioner-over-vores-bevaegelser\/\" rel=\"bookmark\">Reflektioner over vores\u00a0bev\u00e6gelser<\/a><\/li>\n<li><a href=\"https:\/\/andreasbjerregaard.wordpress.com\/2014\/08\/11\/fik-tiger-woods-poppede-sit-baekken-ud-af-led\/\" rel=\"bookmark\">Fik #Tiger Woods poppede sit b\u00e6kken ud af led? #rygsmerter\u00a0#golfskader<\/a><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>A Modern Neuroscience Approach to Chronic Spinal Pain: Combining PainNeuroscience Education With Cognition-Targeted Motor Control Training This blogpost is writting by a good friend and inspirering colleague in the field of physiotherapy, Alexander Hummelsh\u00f8j Kringelbach, who has summerize an article prior to a moderne neuroscience\u00a0path for chronic back pain and how it can be combined [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":1595,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_coblocks_attr":"","_coblocks_dimensions":"","_coblocks_responsive_height":"","_coblocks_accordion_ie_support":"","_crdt_document":"","om_disable_all_campaigns":false,"_surecart_dashboard_logo_width":"180px","_surecart_dashboard_show_logo":true,"_surecart_dashboard_navigation_orders":true,"_surecart_dashboard_navigation_invoices":true,"_surecart_dashboard_navigation_subscriptions":true,"_surecart_dashboard_navigation_downloads":true,"_surecart_dashboard_navigation_billing":true,"_surecart_dashboard_navigation_account":true,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[10,172],"tags":[45,43],"class_list":["post-1593","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-pain","category-spine","tag-pain","tag-spine"],"blocksy_meta":{"styles_descriptor":{"styles":{"desktop":"","tablet":"","mobile":""},"google_fonts":[],"version":6}},"aioseo_notices":[],"jetpack_featured_media_url":"https:\/\/andreasphysioblog.com\/wp-content\/uploads\/2021\/05\/skc3a6rmbillede-2015-05-18-kl-06-53-38.png","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/andreasphysioblog.com\/index.php?rest_route=\/wp\/v2\/posts\/1593","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/andreasphysioblog.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/andreasphysioblog.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/andreasphysioblog.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/andreasphysioblog.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1593"}],"version-history":[{"count":2,"href":"https:\/\/andreasphysioblog.com\/index.php?rest_route=\/wp\/v2\/posts\/1593\/revisions"}],"predecessor-version":[{"id":1596,"href":"https:\/\/andreasphysioblog.com\/index.php?rest_route=\/wp\/v2\/posts\/1593\/revisions\/1596"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/andreasphysioblog.com\/index.php?rest_route=\/wp\/v2\/media\/1595"}],"wp:attachment":[{"href":"https:\/\/andreasphysioblog.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1593"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/andreasphysioblog.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1593"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/andreasphysioblog.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1593"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}