Discussion paper - Attending to pain: 'Mechanisms of musculoskeletal physiotherapy'

Zusman (Zusman M. Mechanisms of musculoskeletal physiotherapy. Phys Ther Rev 2004;9:39–49) offers a welcome paper hypothesising potential neurophysiological mechanisms (habituation and extinction) underpinning musculoskeletal physiotherapy. The strong review of clinical and physiological evidence relating to cellular learning offers a potential theoretical base to practice, supplementing recent physiotherapy literature in this field. His paper raises several themes that relate to the ways in which physiotherapists interpret evidence and the discussion here will focus on these contextual themes.