As physiotherapists, we routinely see patients who present to our clinics with complaints of persistent, chronic pain. These patients are often dissatisfied by other clinicians who have simply dismissed their complaints due to negative diagnostic imaging, clinical patterns that don’t make sense and lengthy rates of healing. As “movement experts”, we often assume that pain is due to a limitation in movement and by allowing one to move better, pain will resolve. But what if in reality, the issue wasn’t pain resulting from movement limitations but the opposite. What if the movement limitation happened as a result of pain? Recent neurophysiologic literature is tackling this “chicken and the egg” debate and suggests that some of the patients we see may not be experiencing pain as a symptom, but instead a disease.
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