Figure 1.

Two exemplary working sub-models developed to support focused TMWG discussions. (A) This scheme illustrates features and activities contributing to loads generated in the spine during daily-living activities. Tissue stresses triggering nociception can exceed tissue tolerances, cause damage, and thus facilitate the development of neuropathic pain. Concurrent feedback phenomena can affect neuromuscular control and function. (B) This scheme illustrates how social, biobehavioral, psychological, and patient-specific features and phenomena can influence central pain processing, pain experience, and ultimately disability. The circle highlights features and phenomena that can contribute dynamic bidirectional (“top-down,” “bottom-up”) influences. Abbreviations: ACE = agreeableness, conscientiousness, extraversion; PTSD = post-traumatic stress disorder.