Chronic pain to #dystonia: how physiotherapy can target cortical reorganisation – speaking this week at BNN Conference

I am delighted to be speaking at the British Neurotoxin Network conference this coming week, giving an opportunity to talk about how we can target the higher centres with wise action and therapy for dystonia. The more recent literature has identified functional changes in a widespread network (e.g./ cerebral cortex, basal ganglia, cerebellum), cortical reorganisation and the importance of non-motor factors. In essence, a biopsychosocial look at this hugely impacting condition.

With a background in pain neuroscience it is fundamental to consider the physical, cognitive and emotional dimensions of any condition. The integrated nature of these dimensions are often key points and areas to target with education, therapy and strategies that seek to create the conditions for change and development, i.e. the treatment and training.

Dystonia is not about the basal ganglia as much as pain is not about damaged tissue. It is about an individual with a conscious experience that has evolved as a consequence of the combination of genes and the life story so far (epigenetics). To seek to change the experience we must consider the biology of the condition such as changes in the neuronal activity, the way in which the person thinks about their problem and the emotional responses. In comprehensively tackling the individual’s situation we can make headway by tapping into our neuroplastic mechanisms that underpin learning and adaptation but for the better. This equally applies for both chronic pain and dystonia, the similarities of which I will be discussing and drawing upon to provoke thought and advancement of the treatment for the latter.

Dystonia Clinic in London

Next: Interesting matters arising from the BNN Conference

RS

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