On Saturday, August 28, 2010, I had the privilege of attending the spine control symposium put forth by the University of Queensland's Centre of Clinical Research Excellence in Spinal Pain, Injury & Health. This was a must symposium for all professionals in the rehabilitation injury who manage low back pain and with the constant growth and debate pertaining to the research in this field, I am truly thankful for such an opportunity to expand my knowledge. As such, I also believe that it is my responsibility to relay that information onto my colleagues and will make an attempt to do so below.
Please be aware that the following information is based on my interpretation of each lecture and therefore, may be subject to "lost in translation".
"Spinal Stability: The six blind men and the elephant" ~ Peter Reeves
A Reductionist vs Systems approach to management
"Motor Control Changes and Back Pain: Chicken, Egg, neither or both?" ~ Lorimer Moseley
Central themes (in red)
“pain and spinal control abnormalities result from implicitly evaluated needs of the organism.”
Pain vs Nociception
It is “seductive” to conclude that recorded activity in c fibers and a-delta fibers will result in pain.
Pain and the Brain
"trunk muscle activity results from the implicitly perceived demands on the trunk."
“we really don’t know whether motor control changes BECAUSE of pain”
– it's a chicken and egg argument.
Considerations pertaining to the concept of nociception and protective motor control changes:
Considerations pertaining to the concept of pain and protective motor control changes:
Motor control as an output of the brain to the muscles:
Pain as an output of the brain to the muscles:
So consequently, the brain asking itself "How Dangerous is this REALLY?" is in his view, what determines back pain.