Changes in Brain Structure and Activation May Augment Abnormal Movement Patterns: An Emerging Challenge in Musculoskeletal Rehabilitation

New research reveals key evidence that possibly explains why some, but not all, patients who sustain musculoskeletal (MSK) injuries go on to develop pain that persists long after the tissues have healed. Several recent publications used brain imaging technologies such as transcranial magnetic stimulation (TMS) and functional magnetic resonance imaging (fMRI) to demonstrate meaningful differences in brain structure and function between individuals with persistently painful MSK disorders compared with those in the asymptomatic population. These observations have led to the hypothesis that alterations in brain structure and activation are linked to the perseveration of abnormal movement and muscle activation patterns, that is, altered motor control [1–3]. Further exploration of this hypothesis may help us develop more effective interventions for MSK disorders.