Addressing sleep problems and cognitive dysfunctions in comprehensive rehabilitation for chronic musculoskeletal pain
Comment on Sleep, pain and exercise: An integrative perspective on neuroscience education: Comments on article titled "Exercise therapy for chronic musculoskeletal pain: Innovation by altering pain memories". [Man Ther. 2015] Exercise therapy for chronic musculoskeletal pain: Innovation by altering pain memories. [Man Ther. 2015]
Exercise therapy for chronic musculoskeletal pain: Innovation by altering pain memories.
Even though nociceptive pathology has often long subsided, the brain of patients with chronic musculoskeletal pain has typically acquired a protective (movement-related) pain memory. Exercise therapy for patients with chronic musculoskeletal pain is often hampered by such pain memories. Here the authors explain how musculoskeletal therapists can alter pain memories in patients with chronic musculoskeletal pain, by integrating pain neuroscience education with exercise interventions. The latter includes applying graded exposure in vivo principles during exercise therapy, for targeting the brain circuitries orchestrated by the amygdala (the memory of fear centre in the brain). Before initiatin…