Centralization vs Peripheralization

Low back pain is the second most common reason for visits to the doctor’s office, behind the common cold. It has been determined that approximately $86 billion dollars is spent annually on the treatment of neck and low back pain. When speaking about disorders of the spinal column, there are many conditions that a person can suffer from. Some of the more common spinal disorders include bulging and herniated discs, spinal stenosis, facet disorders, arthritis, and even fractures of the spine. In certain cases, the nerves that travel to and from the spine, referred to as “Spinal Nerves”, can become compressed and irritated. When this occurs it can create a variety of symptoms ranging from pins and needles, to numbness, to a painful burning and throbbing sensation.

When evaluating if your condition is improving or worsening, the severity of the pain or numbness is not as important the location of the symptoms. For example, if you feel symptoms in the buttock that are rated 9/10 on the pain scale (0/10 is no pain and 10/10 is debilitating pain) and after walking you notice the symptoms are now down to the back of the knee and rated 2/10, this is a sign that the condition has worsened even though the pain rating is much less.

Peripheralization is a term used to describe when these symptoms travel farther from the spine, typically down the extremities. This is a sign that the condition is worsening or an activity that you are performing is causing the symptoms to be exacerbated.

Centralization refers to the symptoms moving towards the spine, or “centralizing”. This is a positive sign that your condition is improving or the nerve root has had pressure removed from it.

We as Physical Therapists can use these signs to help diagnose and also treat neck and back disorders. For example, when we have a patient move their back in a certain direction such as bending forward and the patient reports they now have shooting pain down the back of the leg all the way to the foot, we can say that ‘Flexion’ (bending forward) causes Peripheralization of symptoms. If we then had this patient bend backwards into extension, and their symptoms were no longer felt in their foot but are now only in the buttock, this is a sign of Centralization. Based on this example, we would conclude that the patient’s condition responds favorably to extension and we would prescribe a series of stretches and exercises that are based on this motion.

If you need help determining which treatment options are right for you, call us today.  We treat back and neck pain the Clermont 34711 area!