Cortical reorganisation and chronic pain...

**bernard** · 09-10-2004, 08:47 PM

Rehabil Med. 2003 May;(41 Suppl):66-72. Related Articles, Links

http://www.ncbi.nlm.nih.gov/entrez/q..._uids=12817660

Cortical reorganisation and chronic pain: implications for rehabilitation.

Flor H.

Department of Clinical and Cognitive Neuroscience, University of Heidelberg, Central Institute of Mental Health, Mannheim, Germany. flor@zi-mannheim.de

Recent neuroscientific evidence has revealed that the adult brain is capable of substantial plastic change in such areas as the primary somatosensory cortex that were formerly thought to be modifiable only during early experience. These findings have implications for our understanding of chronic pain. Functional reorganisation in both the somatosensory and the motor system was observed in neuropathic and musculoskeletal pain. In patients with chronic low back pain and fibromyalgia the amount of reorganisational change increases with chronicity; in phantom limb pain and other neuropathic pain syndromes cortical reorganisation is correlated with the amount of pain. These central alterations may be viewed as pain memories that influence the processing of both painful and nonpainful input to the somatosensory system as well as its effects on the motor system. Cortical plasticity related to chronic pain can be modified by behavioural interventions that provide feedback to the brain areas that were altered by somatosensory pain memories or by pharmacological agents that prevent or reverse maladaptive memory formation.

Publication Types:
Review
Review, Tutorial

PMID: 12817660 [PubMed - in process]

**nari** · 15-10-2004, 12:05 PM

Precisely.

But is this knowledge widespread in Rehab medicine and PT?

Many PTs in Rehab still separate "musculo-skeletal" from "neurological" in practice, because they might not think of musculo-skeletal pathology and brain plasticity in the same breath.

nari

**bernard** · 15-10-2004, 12:21 PM

Nari,

precisely, we are seeing boards wich are focussed on neurology and this one is not. :wink:

We are trying to put all the pieces together.

09-10-2004, 08:47 PM	#1
bernard Admin, Moderator... Join Date: Mar 2004 Location: France Age: 56 Posts: 12,013 Thanks: 241 Thanked 135 Times in 89 Posts	Cortical reorganisation and chronic pain... Rehabil Med. 2003 May;(41 Suppl):66-72. Related Articles, Links http://www.ncbi.nlm.nih.gov/entrez/q..._uids=12817660 Cortical reorganisation and chronic pain: implications for rehabilitation. Flor H. Department of Clinical and Cognitive Neuroscience, University of Heidelberg, Central Institute of Mental Health, Mannheim, Germany. flor@zi-mannheim.de Recent neuroscientific evidence has revealed that the adult brain is capable of substantial plastic change in such areas as the primary somatosensory cortex that were formerly thought to be modifiable only during early experience. These findings have implications for our understanding of chronic pain. Functional reorganisation in both the somatosensory and the motor system was observed in neuropathic and musculoskeletal pain. In patients with chronic low back pain and fibromyalgia the amount of reorganisational change increases with chronicity; in phantom limb pain and other neuropathic pain syndromes cortical reorganisation is correlated with the amount of pain. These central alterations may be viewed as pain memories that influence the processing of both painful and nonpainful input to the somatosensory system as well as its effects on the motor system. Cortical plasticity related to chronic pain can be modified by behavioural interventions that provide feedback to the brain areas that were altered by somatosensory pain memories or by pharmacological agents that prevent or reverse maladaptive memory formation. Publication Types: Review Review, Tutorial PMID: 12817660 [PubMed - in process] __________________ Simplicity is the ultimate sophistication. L VINCI We are to admit no more causes of natural things than such as are both true and sufficient to explain their appearances. I NEWTON Everything should be made as simple as possible, but not a bit simpler. If you can't explain it simply, you don't understand it well enough. Albert Einstein bernard

15-10-2004, 12:21 PM	#3
bernard Admin, Moderator... Join Date: Mar 2004 Location: France Age: 56 Posts: 12,013 Thanks: 241 Thanked 135 Times in 89 Posts	Nari, precisely, we are seeing boards wich are focussed on neurology and this one is not. :wink: We are trying to put all the pieces together. __________________ Simplicity is the ultimate sophistication. L VINCI We are to admit no more causes of natural things than such as are both true and sufficient to explain their appearances. I NEWTON Everything should be made as simple as possible, but not a bit simpler. If you can't explain it simply, you don't understand it well enough. Albert Einstein bernard

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15-10-2004, 12:05 PM	#2
nari NeuroNut Evangelist Join Date: Mar 2004 Location: ACT Aust Posts: 7,677 Thanks: 703 Thanked 230 Times in 164 Posts	Precisely. But is this knowledge widespread in Rehab medicine and PT? Many PTs in Rehab still separate "musculo-skeletal" from "neurological" in practice, because they might not think of musculo-skeletal pathology and brain plasticity in the same breath. nari