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4Chronic musculoskeletal pain is the disorder of our decade, and frustrating for both the patient as well as the healthcare practitioner. A cause for this frustration is an inability to understand the inter-relationships between the different bodily systems involved. An understanding of the pathophysiology of chronic musculoskeletal pain will allow for development of a comprehensive and effective treatment plan.In this presentation, a case study will elucidate the ‘pieces of the puzzle’ in a chronic musculoskeletal injury. The symptoms will be related to the pathophysiology and the effectiveness of a logical conservative and comprehensive treatment plan will be demonstrated.Application of this protocol to the general chronic pain population will be discussed.