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...]

In memory of Professor Roberto Perez: a personal reflection.

Professor Roberto Perez, who died on September 7th this year, was a Physiotherapist by profession, and Professor of Pain and Pain Therapy Research at VU University Medical Centre, Amsterdam.  He was the current Chair of the IASP Special Interest Group for Complex Regional Pain Syndrome (CRPS) and Secretary for the International Research Consortium … [Read more...]

Placebo Analgesia from a Rubber Hand

A sense of embodiment, that is, ownership, over one’s own body is a pervasive sensation that is rarely interrupted or lost. Despite being ubiquitous, the influence of embodiment on treatment outcomes is still unknown. If, for instance, the feeling of ownership was lost over a limb, as can be the case following neurological damage, how might this … [Read more...]

Can we train pain-related attention?

Spoiler alert: This blogpost contains null findings.  Paying too much attention to pain is bad. At least, that’s the idea for people who have chronic benign pain, where the pain no longer provides much useful information about the state of the body. People with chronic pain often report being frequently interrupted by pain, meaning that they’re … [Read more...]