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Lorimer Moseley in Tasmania this November

Emma Breheny
30 September 2016

After many years of focusing on the brain, APA Honoured Member Professor Lorimer Moseley, FACP, wants to take clinicians on a journey with him back to nociception—the detection and transmission of ‘issues in the tissues’.

‘The picture that’s emerged in the last 15 years can be summarised as one of fearful and wonderful complexity, even at a spinal cord level,’ he says. ‘Fearful in that it makes our job as clinicians a bit harder, but wonderful because it’s an incredibly sophisticated evaluation system.’

Through his research and work on a forthcoming book with David Butler, Lorimer has been prompted to go back to the basic science of how the body detects, transmits and modifies dangerous tissue events, with the discovery that the biological mechanisms involved are complex and open to modulation by any credible evidence of danger.

Essentially, clinicians need to think more carefully about what’s happening to the danger message from the event in the tissues to when it arrives at the brain.

‘All physiotherapists should have a good understanding of how the danger detectors work and how the information is processed at the spinal cord level. That way, we can be more targeted with what we do, and indeed what we don’t,’ Lorimer explains.

Recently, the extensive discoveries into the science behind pain have placed the profession on a steep learning curve, but Lorimer is confident in his peers’ clinical reasoning skills and track record for implementing the latest evidence.

‘Each individual physiotherapist needs to firstly be informed and then, be courageous enough to say “I’ve got to move with the field here”. ‘Physios are certainly at the leading edge in the scientific realms when it comes to persistent and complex pain.

We now need to be at the leading edge in the clinical space as well,’ he says.

While the profession has shown excellent use of conceptual change strategies to treat people and has integrated physical rehabilitation into a biopsychosocial framework, there are risks of being left behind if clinicians continue to focus purely on the tissue components of pain and its treatment.

After attending his presentation, he wants physiotherapists to take away the idea that there’s not a nociceptive pathway running from a stimulus to a brain response. As for him, he’s looking forward to the event as a step towards research being translated into practice.

‘In many ways I rely quite heavily on clinicians who turn up to things like this. These events keep clinicians pushing the realms of what’s possible in treating complex and persistent pain.’

The TAS Branch Summer Breakfast is happening on Friday 18 November in Hobart. Find out more and register.


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