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Manual Therapy: Manipulation of the Brain?
When a person walks into the clinic with low back pain with primary nociplastic pain mechanisms, I’m armed and ready with a number of treatment ideas. This is thanks to the leaps and bounds made in the last 20 to 30 years in the world of pain science. “Let’s see if you can distinguish this photo of a right hand versus a left hand”, “I’m going to create a quadrant on your lower back and I want you to tell me which quadrant you feel pressure in”, “Let me tell you about the science behind your pain!”. We then find ourselves down this (evidence-based, of course) rabbit hole of treatments, termed graded motor imagery (GMI), with manual therapy falling lower on our list of treatment needs. Can you relate?
