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Pain Modulation

Pain control and modulation is a complex chore that is often the primary reason patients seek the services of rehabilitation professionals.  Modulation of pain begins with an understanding of the various levels of pain modulation and extends to clinical interventions and protocols designed to reduce pain.

Levels of Pain Modulation

Pain modulation is easily classified into 5 discreet levels of interaction.  These levels correspond to either important synaptic junctions, or significant chemical processes involved in the trasmission of pain.

Level 1:  Periphery

Level 1 pain modulation refers to events acting in the periphery of the body, at the source of the pain source. 

Level 2:  Dorsal Horn

Level 2 pain modulation refers to events in the dorsal horn of the spinal cord.  It is here where the Gate Theory of Pain comes into play.

Level 3:  Fast Neuronal Descending Pathways
Level 4:  Hormonal
Level 5: Cortical

Pain Interventions

Manual Therapy


Achilles Tendinopathy

In this month's Members topic we are exploring the foot and ankle with a focus on achilles tendinopathy. This month we have exclusive access to:

  1. 2 FREE chapters from text books Maitland's Peripheral Manipulation by Hengeveld & Banks 2014 and A Practical Approach to Orthopaedic Medicine by Atkins, Kerr and Goodlad. 2010
  2. 4 FREE journal articles from The Foot
  3. An interview with Maitland expert Elly Hengeveld

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