Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Pain in Motion International Research Group(1); Research Foundation - Flanders (FWO), Brussels, Belgium.
Pain in Motion International Research Group(1); Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
Braz J Phys Ther. 2017 Sep-Oct;21(5):378-387. doi: 10.1016/j.bjpt.2017.06.019. Epub 2017 Jul 8.
Nonspecific chronic spinal pain is a common problem within the chronic pain population and is characterized by high social, economic and personal impact. To date, therapists are still struggling in adequately treating these types of patients, as seen in the small and short-term benefits of frequently applied primary care treatments. It is remarkable that despite the well-documented presence of abnormalities in central nociceptive processing in nonspecific chronic spinal pain patients, the implementation of this knowledge in clinical practice is still nearly non-existent.
This paper provides the treatment protocol used in a large randomized controlled trial that aimed to assess the effectiveness of a modern neuroscience approach compared to usual care evidence-based physiotherapy. This comprehensive pain neuroscience treatment program combines pain neuroscience education and cognition-targeted exercise therapy.
Based on previous small-scaled studies, this treatment protocol is expected to normalize central alterations by addressing central nervous system dysfunctions, psychological factors, as well as peripheral dysfunctions in a broader biopsychosocially-driven framework.
非特异性慢性脊柱疼痛是慢性疼痛人群中的常见问题，其特点是社会、经济和个人影响较大。迄今为止，治疗师在充分治疗这类患者方面仍面临困难，因为常见的初级保健治疗往往收效甚微且持续时间短。值得注意的是，尽管非特异性慢性脊柱疼痛患者的中枢伤害性处理异常已得到充分记录，但该知识在临床实践中的应用几乎仍不存在。
本文提供了在一项大型随机对照试验中使用的治疗方案，该试验旨在评估现代神经科学方法与常规护理循证物理治疗的有效性。该综合性疼痛神经科学治疗方案结合了疼痛神经科学教育和以认知为目标的运动治疗。
基于先前的小规模研究，预计该治疗方案将通过在更广泛的生物心理社会驱动框架中解决中枢神经系统功能障碍、心理因素以及外周功能障碍，使中枢改变正常化。
