The neuromatrix theory of pain proposes that pain is a multidimensional experience produced by characteristic “neurosignature” patterns of nerve impulses generated by a widely distributed neural network – the “body-self neuromatrix” – in the brain. These neurosignature patterns may be triggered by sensory inputs, but they may also be generated independently of them. Acute pains evoked by brief noxious inputs have been meticulously investigated by neuroscientists, and their sensory transmission mechanisms are generally well understood. In contrast, chronic pain syndromes, which are often characterized by severe pain associated with little or no discernible injury or pathology, remain a mystery.
by Donald D. Price, Damien G. Finniss and Fabrizio Benedetti
Our understanding and conceptualization of the placebo effect has shifted in emphasis from a focus on the inert content of a physical placebo agent to the overall simulation of a therapeutic intervention. Research has identified many types of placebo responses driven by different mechanisms depending on the particular context wherein the placebo is given. The demonstration of the involvement of placebo mechanisms in clinical trials and routine clinical practice has highlighted interesting considerations for clinical trial design and opened up opportunities for ethical enhancement of these mechanisms in clinical practice.
The Vedāntisation of the Yoga Sūtra or Patañjali: a modern appraisal
In recent years Patañjali’s Yoga Sūtra has been promoted by many teachers
and writers as the normative and quintessential text on yoga. Well, not everyone agrees. David Gordon White claims that ‘…the Yoga Sutra is as relevant to yoga as it is taught and practiced today as understanding the workings of a combustion engine is to driving a car.’
The Biopsychosocial Model 25 Years Later: Principles, Practice, and Scientific Inquiry
by Francesc Borrell-Carrió MD, Anthony L. Suchman MD and Ronald M. Epstein MD
The biopsychosocial model is both a philosophy of clinical care and a practical clinical guide. Philosophically, it is a way of understanding how suffering, disease, and illness are affected by multiple levels of organization, from the societal to the molecular. At the practical level, it is a way of understanding the patient’s subjective experience as an essential contributor to accurate diagnosis, health outcomes, and humane care. In this article, we defend it as a necessary contribution to the scientific clinical method, while suggesting clarifications.
The wide range of human physical activities obscures the relative simplicity of the physics behind movement. From the moment the legendary fish emerged from the water and landed on solid
ground, the development of anatomy was shaped by the need to conserve energy. In this context, the Earth’s gravitational field became another natural resource that our species learned to exploit.
Here Gracovetsky suggests that the coupled motion of the spine and the ability to assemble structures made of compressive and tensile elements using tensegrity techniques top the list of the most important biomechanical constraints on the design of our anatomy.
The principle of core stability has gained wide acceptance in training for prevention of injury and as a treatment modality for rehabilitation of various musculoskeletal conditions in particular the lower back. There has been surprising little criticism of this approach up to date. This article reexamines the original findings and the principles of core stability and how well they fare within the wider knowledge of motor control, prevention of injury and rehabilitation of neuromuscular and musculoskeletal systems following injury.
The fall of the postural–structural–biomechanical model
by Eyal Lederman
Manual and physical therapists often use a postural–structural–biomechanical (PSB) model to ascertain the causes of various musculoskeletal conditions. It is believed that postural deviations, body asymmetries and pathomechanics are the predisposing/maintaining factors for many musculoskeletal conditions. The PSB model also plays an important role in clinical assessment and management, including the choice of manual techniques and the exercise prescribed. However, this model has been eroded by research in the last two decades introducing profound challenges to the practice of manual and physical therapy. This article examines how the sciences are challenging the PSB model, using lower back pain (LBP) as an example.