A clinical commentary 1 published in the Journal of Orthopedic and Sports Physical Therapy decided to look at the role of biological plasticity in LBP (Low Back Pain) as well as its impact on the spine’s sensorimotor control. The commentary, broken into four sections, considered the implications for the clinical management of LBP.

Understanding Pain

Research has shown that pain is a complex phenomenon. It isn’t acceptable to consider pain in peripheral terms (with the involvement of nociceptive neuron activation) anymore. The underlying pain mechanisms have to be considered along with the increasing awareness of plasticity present in biological systems. Recent medical advancements have helped with understanding the critical role of neuroimmune interactions (in the peripheral and central nervous systems) as well as the interaction between the nervous system and body tissues with regards to development and even maintenance of pain; which included low back pain or LBP. Furthermore, the biology involved in tissue changes due to injury or pain also needs to be considered.

A deeper understanding can help with knowing more about the complex nature of LBP pain and interactions with the human motor system. It can lead to an impact on LBP rehabilitation.

What did this Commentary do?

The current clinical commentary has been able to provide an overview of biological plasticity in LBP. Divided into 4 sections, it addressed:

  1. Biology of pain mechanisms.
  2. Neuroimmune interaction in the central nervous system.
  3. Neuroimmune interaction in the periphery.
  4. Brain and peripheral tissue interaction.

What was the Conclusion?

The conclusion presented by this commentary was about how biological processes have an impact on pain experience as all as sensorimotor control from the bottom-up and top-down. Such processes play a role in the processing of nociception and pain. Furthermore, they have a direct role in modifying neural processes linked to muscle movement and sensation as well as the muscle’s capacity to control movement.

However, the commentary made sure to state that additional work is still required to better understand the underlying biological processes. There’s still a lot that we need to learn about the causes behind LBP and recovery strategies.