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Vol. 21. Num. 4.01 July 2017
Pages 225-304
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Vol. 21. Num. 4.01 July 2017
Pages 225-304
Masterclass
DOI: 10.1016/j.bjpt.2017.05.009
Modern pain neuroscience in clinical practice: applied to post-cancer, paediatric and sports-related pain
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Anneleen Malflieta,b,c,d,
Corresponding author
anneleen.malfliet@vub.be

Corresponding author at: Vrije Universiteit Brussel, Medical Campus Jette, Building F-Kine, Laarbeeklaan 103, BE-1090 Brussels, Belgium.
, Laurence Leysena,b, Roselien Pasa,b,e, Kevin Kuppensb,e, Jo Nijsa,b,d, Paul Van Wilgena,b,f, Eva Huysmansa,b, Lisa Goudmana,b,g, Kelly Ickmansa,b,d
a Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium
b Pain in Motion International Research Group,
c Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Belgium
d Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Belgium
e Department of Rehabilitation Sciences and Physiotherapy (REVAKI), Faculty of Medicine and Health Sciences, University of Antwerp, Belgium
f Transcare, Transdisciplinary Pain-management Centre,◊◊ The Netherlands
g Department of Neurosurgery, University Hospital Brussels, Brussels, Belgium
Highlights

  • Generalized hypersensitivity in post-cancer, sports-related and pediatric pain.

  • Rationale for pain education, stress management and cognition targeted exercises.

  • Need to change from a biomedical or psychosocial to an integrated approach.

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Abstract
Background

In the last decade, evidence regarding chronic pain has developed exponentially. Numerous studies show that many chronic pain populations show specific neuroplastic changes in the peripheral and central nervous system. These changes are reflected in clinical manifestations, like a generalized hypersensitivity of the somatosensory system. Besides a hypersensitivity of bottom-up nociceptive transmission, there is also evidence for top-down facilitation of pain due to malfunctioning of the endogenous descending nociceptive modulatory systems. These and other aspects of modern pain neuroscience are starting to be applied within daily clinical practice. However, currently the application of this knowledge is mostly limited to the general adult population with musculoskeletal problems, while evidence is getting stronger that also in other chronic pain populations these neuroplastic processes may contribute to the occurrence and persistence of the pain problem. Therefore, this masterclass article aims at giving an overview of the current modern pain neuroscience knowledge and its potential application in post-cancer, paediatric and sports-related pain problems.

Keywords:
Neurosciences
Central sensitization
Chronic pain

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