Low back pain: A ride through the guidelines.

Our paper[1] in the latest special edition of Best Practice & Research Clinical Rheumatology on back pain aimed to compare, contrast and discuss 3 recent international guidelines for the management of low back pain. The clinical marketplace for low back pain treatments is flourishing. Lots of different professions have carved out their … [Read more...]

Special edition on Back Pain in Best Practice Clinical & Research Rheumatology

Best Practice Clinical & Research Rheumatology is one of the leading journals in the Rheumatology field, and it has a rather unusual format. Each edition is a collection of 10 articles on a particular theme or condition. A special edition on Back Pain comes up about every 4 years or so, and this time around we were invited to edit the … [Read more...]

Are we overly negative when interpreting the results of clinical brain imaging studies?

Two recent studies suggest that brain changes in chronic pain are not all pathological Chronic pain, and the biological mechanisms contributing to pain, are as multifarious and complex as the people who experience them. Because a better understanding of individual differences offers opportunities to design better targeted treatments, … [Read more...]

I believe the (children) undergraduate physiotherapists are the future

The biomedical model of pain remains heavily dominant in most avenues of life. Despite strong scientific support for the biopsychosocial model the vast majority of patients and the public do not understand pain beyond the age-old idea of pain means damage/injury. Unfortunately, holding such an understanding appears to predispose people to develop … [Read more...]

What intensity of activity do you recommend for people with musculoskeletal pain?

Like most people, within my clinical/research practice, I draw upon my own personal every-day experiences. So, when I think about exercise prescription for people with musculoskeletal pain I am always drawn back to a story from my halcyon days of youth playing five-a-side in-door staff football on Friday afternoons at 4pm. On one particular … [Read more...]

Chronic pain following total knee replacement

Approximately 20% of patients following total knee replacement (TKR) suffer from chronic postsurgical pain. Numerous non-modifiable risk factors for the development of chronic postsurgical pain have been identified in the literature, for example female gender. Potentially modifiable risk factors have also been identified such as psychosocial … [Read more...]

Is there a neural basis for sensorimotor impairments in non-specific low back pain?

Globally, low back pain causes more disability than any other condition. Unfortunately, most people will experience this condition at some point in their lives. Treating low back pain is very challenging because in up to 85% of cases, the pain cannot be attributed to a specific spinal pathology, such as a fracture or herniated disc. This is called … [Read more...]

Twin Studies Lend New Insights into Link between Depression and Back Pain

The prevalence of patients concurrently suffering from both depression and low back pain is high and the combination of these conditions is associated with treatment difficulties, such as the need for engaging multi-professional teams and higher rates of health care utilization and management costs (Baumeister et al., 2012; Greenberg et al., 2003). … [Read more...]

What does current Complex Regional Pain Syndrome (CRPS) rehabilitation look like?

As a practicing clinician I recognise that CRPS is notoriously difficult to treat. International clinical guidelines recommend rehabilitation therapies as a core treatment for CRPS (1,2,3). They suggest a very broad range of possible treatments with some variation across the guidelines. Despite these recommendations, a recent Cochrane review (4) of … [Read more...]

Editor’s picks: Clinical prediction rules: Use the babies and throw the bathwater?

Over this holiday season we are publishing our Editor’s picks of 2017 for you to read and enjoy again.  — There are easily a thousand clinical prediction rules (CPRs) related to managing musculoskeletal pain. Okay, maybe a thousand is an exaggeration. My point is there are many. All designed with the aim of helping clinicians to make more certain … [Read more...]