Broadly speaking, Neurodevelopmental Disorders (e.g., Developmental Coordination Disorder, ADHD) have some striking similarities to chronic low back pain (see picture). The differences between “healthy controls” and those with the condition can be used to identify meaningful subgroups. For those that have heard me speak, it is my opinion that neurodiverse characteristics in chronic musculoskeletal pain represent an important subgroup. A neurological presentation requires blending an orthopaedic approach with a neurological approach. Primitive reflex inhibition, postural reflex facilitation and specific sensory motor rehabilitation are very useful in those in which the causation is not progressive (e.g., atypical birth history).

A couple of things we can learn from Neurodevelopmental Disorders:

  1. Sub-classification is important
  2. Targeted rehabilitation is superior to non targeted
  3. Research on chronic musculoskeletal pain needs to exclude subjects with neurodevelopmental disorders. It is possible some of the differences between groups could be confounded by the differences found in neurodevelopmental disorders