UNDERSTANDING NEUROPLASTICITY IN CHRONIC PAIN: A PHYSIOTHERAPY PERSPECTIVE

Abstract

Chronic illness is among the most common and disabling illnesses, affecting millions of people worldwide. Acute pain is typically of a shorter duration, acting as protection and reduction in activity once tissue healing occurs, but chronic pain (which can last months or years lacking clear elements for survival) continues with little evidence of ongoing tissue damage. Emerging neuroscience data suggests that chronic pain correlates with neuroplasticity, or the CNS ability to change its architecture and function following internal or external stimulation. Neuroplastic changes happen in the brain spinal cord and PNS Neuroplasticity is essential for learning, memory and recovery after injury, but maladaptive neuroplasticity contributes to chronic pain, persistent movement alteration (movement patterns), hypersensitivity, psychosocial distress and decreased quality of life. The knowledge of these mechanisms has revolutionized the current concept of pain relief and rehabilitation. Physiotherapy can modulate neuroplastic changes using such components of therapeutic exercise, pain neuroscience education, motor control training (especially neuromuscular rehabilitation), graded exposure, cognitive strategies and movement rehabilitation. Modern physiotherapy has moved beyond a tissue- and biomechanics-centered model and also accounts for what is changing within the nervous system. Neuroplasticity of Chronic Pain: A Physiotherapy Perspective chapter content Neuroplasticity: It reviews the processes of neuroplasticity, its clinical implications, assessment methods of neuroplasticity-related changes during recovery and treatment strategies in physiotherapy as well as their advantages and limitations. An understanding of the phenomenon of neuroplasticity has equipped physiotherapists with novel observation tools and a basis for developing more effective and evidence based treatment strategies for individuals with chronic pain.