Although evidence of maladaptive motor and sensory cortex changes in patients with chronic musculoskeletal conditions is continuously emerging, most rehabilitation approaches continue to focus on local and peripheral structural dysfunction. To address these central nervous system (CNS) adaptations, clinical evaluation and management strategies are described. Suggested valuation elements include motor control, fear avoidance and central sensitization. Active management techniques suggested are minimal use of passive techniques, education on pain neuroscience, sensorimotor training and self-efficacy building.