Aust J Physiother. 1999 ; 45(3): 215-221.

The clinical application of central pain mechanisms in manual therapy.

Shacklock MO.

Shacklock Physiotherapy, Adelaide, SA, 5000, Australia. [email protected]

Treatment of central pain mechanisms is a new horizon for manual therapists. This paper presents key points about central pain mechanisms and how they can be treated by the manual therapist. Included are facets of conditioning, memory and learning; some types of central problems and cognitive-behavioural and physical techniques for use by manual therapists. The concept of treatment through central pain mechanisms is concluded with a case study illustrating the relevant clinical application. Education of central pain mechanisms and, for that matter, the pain paradigm, should become an integral part of physiotherapy education.