Mislocalization of Sensory Information in People With Chronic Low Back Pain

Wand, Benedict M; Keeves, Jemma; Bourgoin, C.; George, Pamela Jane; Smith, Anne; O’Connell, Neil E; Moseley, G. Lorimer

doi:10.1097/ajp.0b013e318274b320

Cited by 43 publications

(39 citation statements)

References 59 publications

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“…In such tasks, the jaws of a mechanical calliper are placed on the surface of the skin and spread apart gradually until the patient is able to discern two points, instead of one. Further, when asked to identify the location of the unseen tactile stimulus, patients with CPRS and CLBP commonly report the wrong location (Moseley et al, 2008c;Wand et al, 2013). Reduced tactile discrimination and mislocalisation have also been reported in phantom limb pain (Ramachandran et al, 1995;Flor et al, 2001;Ramachandran and Altschuler, 2009).…”

Section: Tactile Sensationmentioning

confidence: 99%

Sensing the body in chronic pain: A review of psychophysical studies implicating altered body representation

Tsay

Allen²,

Proske

et al. 2015

Neuroscience & Biobehavioral Reviews

125

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Section: Tactile Sensationmentioning

confidence: 99%

Sensing the body in chronic pain: A review of psychophysical studies implicating altered body representation

Tsay

Allen²,

Proske

et al. 2015

Neuroscience & Biobehavioral Reviews

125

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“…In line with pain assessment, pain neuroscience research has also brought attention to the potential different role of body charts (George, Bialosky, Wittmer, and Robinson, 2007;Wand et al, 2013). Traditionally upon arrival at a physical therapy clinic a patient was given a "body chart" and asked to indicate where they hurt.…”

Section: Assessing Painmentioning

confidence: 99%

Listening is therapy: Patient interviewing from a pain science perspective

Diener

Kargela

Louw

2016

Physiotherapy Theory and Practice

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The interview of a patient attending physical therapy is the cornerstone of the physical examination, diagnosis, plan of care, prognosis, and overall efficacy of the therapeutic experience. A thorough, skilled interview drives the objective tests and measures chosen, as well as provides context for the interpretation of those tests and measures, during the physical examination. Information from the interview powerfully influences the treatment modalities chosen by the physical therapist (PT) and thus also impacts the overall outcome and prognosis of the therapy sessions. Traditional physical therapy focuses heavily on biomedical information to educate people about their pain, and this predominant model focusing on anatomy, biomechanics, and pathoanatomy permeates the interview and physical examination. Although this model may have a significant effect on people with acute, sub-acute or postoperative pain, this type of examination may not only gather insufficient information regarding the pain experience and suffering, but negatively impact a patient's pain experience. In recent years, physical therapy treatment for pain has increasingly focused on pain science education, with increasing evidence of pain science education positively affecting pain, disability, pain catastrophization, movement limitations, and overall healthcare cost. In line with the ever-increasing focus of pain science in physical therapy, it is time for the examination, both subjective and objective, to embrace a biopsychosocial approach beyond the realm of only a biomedical approach. A patient interview is far more than "just" collecting information. It also is a critical component to establishing an alliance with a patient and a fundamental first step in therapeutic neuroscience education (TNE) for patients in pain. This article highlights the interview process focusing on a pain science perspective as it relates to screening patients, establishing psychosocial barriers to improvement, and pain mechanism assessment.

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“…Patients with chronic LBP have reduced lumbar tactile acuity, in terms of enlarged two-point discrimination thresholds (Catley et al, 2014), problems localising tactile inputs to the back (Wand et al, 2013), poor trunk motor imagery performance (Bray and Moseley, 2011;Bowering et al, 2014) and impaired perception of the sensorimotor aspects of visually displayed movements (de Lussanet et al, 2012;de Lussanet et al, 2013). It was shown that patients with LBP have lower lumbosacral proprioceptive acuity (Brumagne et al, 2000), and show blunted responses to lumbosacral proprioceptive stimulus (Brumagne et al, 2008;Janssens et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

The development of the Dutch version of the Fremantle Back Awareness Questionnaire

Janssens

Goossens

Wand

et al. 2017

Musculoskeletal Science and Practice

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Mislocalization of Sensory Information in People With Chronic Low Back Pain

Abstract: These data add to a growing body of evidence suggesting that disturbed self-perception is a feature of CLBP. It is plausible that altered self-perception is maladaptive and contributes to the maintenance of the problem and may represent a target of treatment for CLBP.

Cited by 43 publications

References 59 publications

Sensing the body in chronic pain: A review of psychophysical studies implicating altered body representation

Sensing the body in chronic pain: A review of psychophysical studies implicating altered body representation

Listening is therapy: Patient interviewing from a pain science perspective

The development of the Dutch version of the Fremantle Back Awareness Questionnaire

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