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Application of Spinal Segmental Physiology to Evaluating Chronic Pain
Practical Pain Management, 06/23/09

Beck JL - A new diagnostic algorithm for the evaluation of the chronic pain patient is being presented in this series of articles in Practical Pain Management. It is called the P.A.N.E. Process and stands for ‘Practical Applications of Neuropostural Evaluations.’ Although the P.A.N.E. Process is derived entirely from Western science, it differs in a significant number of ways from the familiar symptom-directed, anatomic approach of current Western Medicine. This article presents the second stage of the P.A.N.E. Process: evaluation for spinal segmental dysfunction as a cause of altered neuroposture and chronic pain. These tests are called the "R" Tests. The exam process is quite simple, requiring only a few moments, but can help the clinician identify when spinal segmental dysfunction is the primary cause of a chronic pain condition - even when the patient does not have spinal pain. It is the author’s opinion that we have come to rely too much on radiological and electro-diagnostic technology, and not enough on functional testing. Chronic pain is usually a functional condition. The novice physician entering practice quickly learns that back pain encompasses far more problems than answers from the standard methods.

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