Low-back pain patients learn to adapt motor behavior with adverse secondary consequences

ABSTRACT: We hypothesize that changes in motor behavior in individuals with low-back pain are adaptations aimed at minimizing the real or perceived risk of further pain. Through reinforcement learning, pain and subsequent adaptions result in less dynamic motor behavior, leading to increased loading and impoverished sensory feedback, which contributes to cortical reorganization and proprioceptive impairments that reduce the ability to control lumbar movement in a robust manner