Physiotherapist love trends. The current trend which has been around for a good number of years now is that all pain, especially persistent pain is a result of some level of central nervous system (CNS) dysfunction, an output of the brain effectively.
As such it is argued we should now forget about structure and the periphery and simply target the central nervous system when treating clients. This basically means talking therapy and exercise, so vociferously promoted by the biopsychosocial pain model zealots. Hands on treatment is now considered an act of high treason and anyone admitting to doing so risk being shamed and admonished. As for acupuncture or dry needling, such techniques are considered by these folk as being so worthless you’d be better off rolling around in a thorn bush for the good it would do you.
Now of course the CNS plays a role in how we perceive pain, how could it not? Given how inextricably linked the peripheral (which supplies the spinal structuctures and limbs etc) and central nervous systems are both physiologically and anatomically, one will of course influence the other. For some, pain may be due to a combination of both peripheral and central nervous system 'wind up'.
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