A pain that has centralized means that it has gone the other way round; for example, a referred sciatica pain that goes down the leg, sometimes even to the little toe, will gradually work its way up to the back, only to become a very localized pain, the size of a thumb.

Mark tells us about a patient, Ian, he saw at the practice. Ian had been in pain every day for 8 years. Ian’s job as a salesman required him to drive for 8 hours a day, and because of his pain, he had to stop every hour or even every 30 minutes to lie on the ground outside, whether it was snowing, hailing, raining, summer or winter.

Ian arrived at Mark’s office in agony. He’d been suffering from back pain for 8 years.  After a long, detailed and thorough interrogation, Mark asked him to perform several repetitions (in flexion). At the end of the session, Ian was almost pain-free. His pain had centralized and almost disappeared. He continued to do his flexion sets in the weeks that followed, and Mark still sees him to make sure everything’s okay. For several years now, Ian has been doing very well and is pain-free. In Ian’s case, it was the flexion movement that provided the solution. Sometimes it’s extension, or lateral shift, depending on the person and their pain.