Pain as a threat to the social self

Times are changing. Our understanding of pain from a purely biomedical perspective has evolved to a biopsychosocial perspective of pain. Intuitively, pain has long been recognized as an experience that can fundamentally threaten our need to feel safe, both physically and psychologically. But what does it mean to say that pain is social? In earlier … [Read more...]

Tilting at Trigger Points

In the recent blog post some may feel it is remiss of Fernández-de-las-Peñas not to have at least considered the possibility that the clinical phenomena attributed to the so-called latent TrP (trigger point) could also be explained as arising from sensitised peripheral neural tissue. This concept was suggested nearly 25 years ago [1] and again more … [Read more...]

Trigger Points and the Nervous System: Myth or Reality?

There is a worldwide debate about whether trigger points (TrP) can be considered a relevant clinical entity with their own diagnostic criteria,[1] whether TrPs are just sensory and motor phenomena, secondary to other diseases, or whether the TrP phenomena are reliable enough to be meaningfully categorized.[2] The debate extends to the mechanisms … [Read more...]

How do pain and working memory interact? Can we decrease pain by improving working memory?

One of the main questions for us as pain researchers is how we can reduce pain.  We already know that painful stimuli such as electrical shocks involuntarily grab our attention because our body prioritizes them to protect us from harmful stimuli. Also, people who have chronic pain pay more attention to painful information and it is possible that … [Read more...]

Two-point discrimination test: the time has come for standardization

As we recently highlighted (see also here and here and M. Catley’s post) tactile acuity assessment has become an increasingly popular area of research in chronic pain. Most two point discrimination (TPD) studies focus on chronic low back pain, but TPD has also been investigated in other conditions that are challenging to treat, e.g. complex … [Read more...]

Acceptance and Commitment Therapy for Prevention of Chronic Pain and Opioid Abuse

Chronic post-surgical pain (CPSP) is a common and debilitating problem that occurs in a significant number of patients following surgery. Orthopedic surgeries are consistently associated with high postoperative pain, with the prevalence of chronic pain at 3–24 months to be 20% or more after Total Knee Arthroplasty (TKA) and 8% or more after Total … [Read more...]

Some good news for America’s Back Pain Problem?

A couple of weeks ago, I had a mock interview for a new research fellowship with our national research council. In my rather sheltered life, these interviews are a rather big deal – whether or not I am to remain a government-funded medical researcher hangs on the line and the chances are intimidatingly thin. The mock interview then, aims to give … [Read more...]

Yelp Offers New Insights into the Pain Management Experiences of Patients and Caregivers

A team of researchers, physicians, and computer scientists at Penn’s Center for Health Care Innovation have explored the various ways in which social media data can be used to investigate some of the most pressing issues in medicine. Some topics investigated include inequality in medical outcomes among different populations, trends among people … [Read more...]

Models of Care In Musculoskeletal Pain Management – Should We Be Learning From The Compensation ‘Comparator’ Group?

Contextual factors play a critical role in musculoskeletal pain[1] and consequently also pain related disability[2]. This is demonstrated powerfully in the compensation arena. The compensable context is associated with comparatively inferior outcomes, including poorer responses to interventions[3-5]. In a circular argument, the context itself is … [Read more...]

The Challenges of Translational Pain Research

Over the past ten years a number of articles have been written detailing the success of researchers in understanding the neurobiology of pain. Over this same period, however, little progress has been made in the development of new long-term interventions for the treatment of chronic pain. Perhaps the most compelling commentary on this topic is the … [Read more...]