Presentation summary

1.Lumbar radiculopathy including lumbar problems
2.Cervical radiculopathy including cervical problems
3.Shoulder instability including shoulder problems
4.Patellofemoral pain syndrome including knee problems
5.Cuboid syndrome including ankle and foot problems

The writing below summarizes cognitive behavioral therapy in musculoskeletal
disorders among my concepts.

☆Cognitive Behavioral Therapy in Musculoskeletal Disorders☆

The pain I feel now refers to emotional discomfort that can be predicted through past experiences related to pain. This emotional discomfort related to pain means emotional
suffering, and emotional su􀆯ering experiences new pain over time and space. The
discrepancy between cognition and behavior causes emotional discomfort related to pain. And the distorted cognition of pain causes abnormal behavioral changes.

In musculoskeletal disorders, cognitive behavioral therapy does not treat pain, but rather manages emotional discomfort related to pain. Abnormal behavioral changes due to pain cause abnormal movement patterns and avoidance behaviors. Abnormal
Movement patterns immediately respond to pain through the shoulder, hip, and spine, and unconsciously cause imbalances in the lumbar stabilization muscles along with movement patterns that avoid pain. Avoidance behavior unconsciously causes lumbar deviation in response to pain and causes imbalances in the lumbar stabilization muscles. These changes in movement patterns and avoidance behaviors cause intrapelvic torsion through imbalances in the lumbar stabilization muscles. Intrapelvic torsion causes gait through movement of the lumbar spine as well as bilateral ilium movements, including the hip joints, along with sacral torsion. Sacral torsion also plays an important role in producing movements such as walking along the sacral axis.

Pain changes behavior not only through emotional discomfort but also through distorted cognition of pain. Therefore, cognitive behavioral therapy modifies abnormal behavioral changes and corrects distorted cognitions of pain through modified behaviors to relieve emotional discomfort. In addition, because abnormal behavioral changes cause sacral torsion due to imbalances in the lumbar stabilization muscles, cognitive behavioral therapy in musculoskeletal disorders modulates pain through the diagnosis of sacral torsion types.

In cognitive behavioral therapy, behavioral changes contribute to reducing emotional discomfort because of positive motivation. And repetitive behavioral changes not only reduce emotional discomfort but also learn positive emotions according to behavioral changes and are remembered as past experiences. Therefore, cognitive behavioral therapy can correct distorted cognitions of pain through repetitive learning of changed behaviors.

Patients may think that they perceive pain, but the sensations they feel are mistaking emotional suffering for pain. In addition, diagnosis and treatment by physicians that do not take emotional suffering into account may be thought to be a structural interpretation of changes in movement patterns and avoidance behaviors due to pain.

The goal of pain treatment in musculoskeletal disorders is to control not only the pathological phenomena due to structural damage, but also the emotional discomfort caused by structural or functional damage.