Article

Teaching people with chronic low back pain (CLBP) about the neurobiology and
neurophysiology of their pain is referred to as pain neuroscience education (PNE). There is growing evidence that when PNE is provided to patients with
chronic musculoskeletal pain, it can result in decreased pain, pain
catastrophization, disability, and improved physical performance. Because the aim
of PNE is to shift the patient's focus from the tissues in the low back as the
source of their pain to the brain's interpretation of inputs, many clinicians
could mistakenly believe that PNE should be a "hands-off," education-only
approach. An argument can be made that by providing manual therapy or exercise to
address local tissue pathology, the patient's focus could be brought back to the
low back tissues as the source of their problem. In this narrative literature
review, we present the case for a balanced approach that combines PNE with manual
therapy and exercise by considering how manual therapy can also be incorporated
for interventions with patients with CLBP. We propose that as well as producing
local mechanical effects, providing manual therapy within a PNE context can be
seen as meeting or perhaps enhancing patient expectations, and also refreshing or
sharpening body schema maps within the brain. Ideally, all of this should lead to better outcomes in patients with CLBP.

Langue : ANGLAIS