Designing next-generation psychotherapy in pain

People are often surprised at how badly our treatments for chronic pain perform. Pharmacological, surgical, rehabilitative, and psychological treatments all underperform against our expectations, wishes and ideals (Eccleston and Crombez, 2017). The good news, however, is that there is fervent research activity in the pharmacological and surgical … [Read more...]

Pain education enhances the pain-relieving effect of exercise in healthy adults

Exercise may be one of the most universally beneficial interventions for people with chronic pain. Despite this, many patients with chronic pain avoid exercise because it can worsen their pain. These contrasting effects show that exercise does have the capacity to influence pain, for better or for worse, but the mechanisms of how exercise does this … [Read more...]

Racial/Ethnic Differences in Pain: Does Biology Play a Role?

In the 21st century, it is hard to imagine pain was once conceptualized as a simple sensory experience. Indeed, pain might be easier to treat if the experience were linearly related to the amount of tissue damage. For better and worse, our experience of pain is anything but straight-forward; it is wrapped up in a complex interaction between … [Read more...]

Attention bias in complex regional pain syndrome: it’s not just about the body

Some of the difficulties that people with Complex Regional Pain Syndrome (CRPS) report in feeling and moving their affected limb appear to be similar to a condition called hemispatial neglect [1,2]. Patients with ‘neglect’ have difficulty attending to one side of the environment following brain injury, and the similarities between the two … [Read more...]

Is finding a pukka neurosignature for pain on the top of our discovery list?

Earlier this month, Nature Reviews Neurology published a Consensus Statement from a presidential taskforce of the International Association for the Study of Pain (IASP), on the use of brain imaging tests for chronic pain. The statement answers the question of whether chronic pain can be identified ‘objectively’. Whether or not brain imaging can … [Read more...]

Leadership and Listening in Collaborative Health Care

Why is listening to people so hard? A 4-Part Clinical Collaboration Reflection Part 4 Our daily work with people in pain is a leadership position. It would be nice to wait for a system overhaul, and new models of care to be created, but human suffering doesn’t fit into that timeline. We have people in front of us everyday, and we know that even … [Read more...]

Bring on The Pain Revolution

Why is listening to people so hard? A 4-Part Clinical Collaboration Reflection Part 3  What does it take to change a cultural narrative around a healthcare issue like pain? It takes a Revolution. When Lorimer pitched the idea of a Pain Revolution bike ride, where we would take the science out of the lab and into people’s real lives, I was … [Read more...]

Scaling Collaborative Care

Why is listening to people so hard? A 4-Part Clinical Collaboration Reflection Part 2 Collaborative care, in it’s current form, is not very scaleable. In chronic pain care, we have a situation where the people who need help most, have the least access to services (1). They have the highest barriers to change, the most complex social situations … [Read more...]

Calls to Collaborative Care

Why is listening to people so hard? A 4-Part Clinical Collaboration Reflection Part 1 Whatever happened to “health” and “care” in healthcare?  We’ve woken up in 2017 to an internet bursting with calls to fix the broken system(1) and re-humanise health, and they fill me with equal parts hope and dread. I don’t want to read another call to arms … [Read more...]

A misty, multidimensional crystal ball

Wouldn’t it be great if we could give our patients a prognosis that is evidence based and tailored to their presentation? Chronic low back pain (CLBP) is, however, a complex multidimensional problem, and over 200 factors (from multiple dimensions such as demographics, psychological, social, health and lifestyle etc.) may be prognostic for people … [Read more...]