I recently received an email from Vanessa Milne who is doing Post Graduate Studies in Pain Science at University of Sydney with the who’s who of Australian pain stuff - Nicholas, Cousins, Siddall, Keast.... an impressive line up that. Anyway, Professor Michael Cousins is leading the way in an impressive and ambitious attempt to put pain on … [Read more...]
Lumpers, Splitters and STarTers
October 21, 2011 By 17 Comments
In recent years there have been many debates about the disappointing results from clinical trials of treatments for non-specific low back pain. One argument has been about the targeting of treatment for back pain. Many folk have argued that trials which apply a one-size-fits-all treatment fail to show a reasonable effect because amongst those who … [Read more...]
In the mind or in the brain? Central sensitization in chronic fatigue syndrome
October 11, 2011 By 1 Comment
Do you recall patients complaining of hypersensitivity to light, sound, cold, stress or mechanical pressure (e.g. jewellery on the neck)? This often relates to hypersensitivity of the central nervous system, a mechanism referred to as central sensitization. Brain orchestrated inhibitory mechanisms no longer work properly, while the brain activates … [Read more...]
What happens when systematic reviews tell us different things?
September 27, 2011 By 6 Comments
Conventional wisdom tells us that when we want an answer to a clinical question, such as what is the evidence for treatment ‘X’, we should look to systematic reviews because they collate all the available evidence on that topic. Problematically though, sometimes systematic reviews on the same topic don’t all give us the same conclusions. This … [Read more...]
Graded motor imagery, one shark and two men on a mission
September 25, 2011 By 5 Comments
We recently got an email from the guys at Neuro Orthopaedic Institute, or NOI as they are more commonly known. Now, none of us at BiM are part of NOI but we like the stuff they do and thought that this latest venture was worth giving a shout out for. The feedback we got from people who attended has been great. This is what they did.... Tom … [Read more...]
There is no such thing as a new idea continued
September 22, 2011 By 5 Comments
(continued from last post)…Socio-cognitive models have been used by health psychologist to increase our understanding of a variety of health behaviours. What about disability associated with low back pain? If we can think of disability as made up of specific behaviours then and if these behaviours are intentional it follows that people with … [Read more...]
There is no such thing as a new idea
September 20, 2011 By 5 Comments
For my first BIM post I wanted to blog about an article that I read some years ago that had probably the biggest impact on my thinking on low back pain and disability and 15 years later still informs the way that I think about pain and disability. Around the mid 1990s when I first started research in low back pain a UK-based health psychologist … [Read more...]
Tennis elbow? You’re bleeding me dry!
September 13, 2011 By 4 Comments
A trial of a very very very old treatment for tennis elbow just grabbed my attention. In fact the treatment in question probably precedes tennis itself. All in all it kind of reminded me of this piece of British comedy vintage: httpvh://www.youtube.com/watch?v=Ez3BFGXR02A Yep, this is a trial of leech therapy for tennis elbow, proving the old … [Read more...]
Kahil Gibran on pain: Prophetic or pathetic?
August 25, 2011 By 16 Comments
Jason Tonley from Kaiser Permanente in LA, reminded me of this old beauty from Kahlil Gibran’s classic The Prophet. Now this stuff is written by a Lebanese American artist and poet, who was raised in poverty without formal education but with a gambling father who was jailed. After being evicted, his mum took him and his sisters and brother to … [Read more...]
rTMS and chronic pain: Our two penny’s worth
July 5, 2011 By 9 Comments
Some of you might have heard of repetitive transcranial magnetic stimulation (rTMS) and its use in chronic pain. Basically rTMS uses magnetic fields to generate electrical currents within the brain. This is a direct way of altering neuronal firing or excitability in the brain and a number of research groups have been investigating whether it might … [Read more...]
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