Ginger,

I certainly agree that the CNS has an overwhelming contribution to someones pain state and adapts itself to an ongoing pain state. What I am trying to suggest is that pathology also may exist concurrently with the central signs. Obviously these exist in different proportions in different patients groups.

However... are you telling me that someone who walks into your clinic with a diagnosis of hip OA and objective signs that support this would be treated by mobilisations of the PIV joints?????