With the advent of neuroscience exploring issues associate with neuroplasticity, it has become increasingly clear that in a certain patient population, physical touch and movement, essential for recovery, could actually pose a threat. This includes conditions such as complex regional pain syndrome (CRPS) (old RSD), phantom limb pain, peripheral neuropathy, spinal cord injuries and more. With persistent input to the central nervous system and brain, various long-lasting changes occur including cell death, change in brain maps of the body, neurotransmitters, receptors and various pathways associated with pain. These changes manifest themselves with clinical issues such as neglect, allodynia, hyperalgesia, mirror pains, spreading pain, widespread sensitization and problems with laterality recognition. Physical testing of patients with pathological changes in their mapping will include two-point discrimination, pressure-pain threshold testing, nerve palpation, localization, graphesthesia, neuro- dynamics, laterality and mapping of body parts. The same neuroplastic events associated with pain, however, produce unique avenues to treat patients often too sensitive for physical movement. The brain’s perception of threat can be altered with cognitions (therapeutic neuroscience education), but also via other senses, directly aiming at the faulty mapping of the brain in pain. Treatments discussed, demonstrated and practiced will include graded motor imagery, sensory discrimination, mirror therapy, graphesthesia and neuroscience education. 

By the end of the course, a successful learner will be able to: