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Pain Science

Episode
1 of 16
Published
Oct 27th, 2018
Run Time
24m 29s
Topic
The back course
Your Instructor
Sigbjørn Hjorthaug
Sigbjørn Hjorthaug
The last 20 years, Sigbjørn has been focusing on sharing his extensive knowledge within Physical Therap...

Episode Summary

Explore a modern, evidence-informed approach to low back pain that goes far beyond structure alone, combining pain science, the biopsychosocial model, movement, and hands-on care. You’ll discover how fear, beliefs, lifestyle, and loading shape pain—and how to guide recovery with clearer reasoning and greater confidence.

Lumbar spine assessment and treatment are presented through a broad biopsychosocial framework rather than a purely structural model. Learners are introduced to key approaches used in back pain, including pathoanatomical, psychosocial, neurophysiological, mechanical loading, motor control, and symptom-based models, with emphasis on understanding the whole person instead of focusing only on tissue damage. A major focus is pain science: pain as a protective brain output influenced by threat, fear, beliefs, stress, sleep, activity, and social factors. The explanation highlights why MRI findings and structural changes do not always match symptoms, why treatment effects are hard to isolate, and how communication, safety, trust, and expectation can influence outcomes. Practical strategies for reducing sensitization are covered, such as aerobic exercise, sleep, education, goal setting, and graded exposure. The teaching also outlines areas that will be explored clinically, including cognitive functional therapy, posture, core stability, flexion, extension and rotation patterns, hip-lumbar relationships, pelvic girdle issues, gluteal and hamstring tendinopathy, hands-on techniques, and when surgery may be appropriate. Movement is presented as central to recovery, even when some pain is present.
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Communication

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