Research into the role of the brain in chronic pain
Every now and then I stumble across a paper that evokes the reaction “I wish I’d though of that”. Such a paper recently turned up in the journal Rheumatology by Majid Artus and his colleagues at Keele University. They performed a systematic review that aimed to assess not the effectiveness of interventions but instead the overall pattern of … [Read more...]
When I remember primary school, I remember one of my teachers cutting snot out of his nose with a pair of scissors when he thought no-one was looking. When I remember high school, I remember teachers saying two things, mainly. "Lorimer, LORIMER, are you with us?" and "Well you certainly have a good imagination..." In fact, imagining things … [Read more...]
Having written a number of posts on acupuncture (see here, here, and here) I guess my particular biases are reasonably apparent. So imagine my surprise when a large RCT published in the journal “Pain” reports a significant and substantial effect of Chinese acupuncture in comparison with sham acupuncture or conventional orthopaedic therapy for … [Read more...]
I met a fellow called Max. He was impressive with his command of the facts. He does some cool studies. He's not one of the Luddies. And certainly not one of the hacks. That is what happens when one is a bit too low on sleep. Which I am. But Max is not. Max works in beautiful Oxford and has done some excellent work looking at the use of … [Read more...]
Some time ago, I wrote this paper, at the request of the journal Physical Therapy Reviews, on reconceptualising pain. It is a little old now but it has come to be a bit of a position paper. The position has four fundamentals, none of which will be very surprising to anyone I imagine: (i) pain does not provide a measure of the state of the … [Read more...]
We just came across a fancy patient information form that was given to a patient after an assessment by a clinician. The form just blew our minds (but not in a good way) because it seemed to be the perfect clinical tool for generating ongoing pain and disability, and all by the simple process of ramping up the fear. So, just for fun, we thought … [Read more...]
Intravenous Immunoglobulin in Complex Regional Pain Syndrome Andreas Goebel on the results of his latest clinical trial .Just imagine the causes of some chronic pains are completely different from what you had thought. Complex Regional Pain Syndrome is a severe pain which persists after limb trauma. You are unlucky if you develop this nasty … [Read more...]
When my daughter hurts herself, her placebo of choice is a “magic kiss”. This therapeutic intervention must be applied with care specific to the area of injury. Anecdotal evidence suggests that it is very effective. I use placebo freely at home but is it right to do this in the clinic? In a recent post I suggested that we can be more confident … [Read more...]
It’s only the first week into my research year and the mountain of literature surrounding motor imagery is daunting. After having analyzed an article[1] outlining left-right hand judgments I feel I am in the position to impart my “dummy’s guide to motor imagery”. Motor imagery is the mental process by which an individual simulates a … [Read more...]
Acupuncture is all the rage in the treatment of pain. Recent clinical guidelines in the UK recommend it in the treatment of persistent back pain. This decision is somewhat controversial and has led to much discussion, because while the research in back pain suggests people feel somewhat better after acupuncture, it also demonstrates with clarity … [Read more...]
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