A simple question with a complex answer: Why do people seek healthcare?

The obvious answer to the question, why do people seek healthcare for musculoskeletal conditions might be because of pain, loss of function, or disability. To some degree, all of these reasons are suitable answers.  However, as the British economist E.F. Schumacher once stated “everything can be seen directly except through the eye through which we … [Read more...]

Difficulties with cluster randomized trials in primary care

Cluster randomized trials (cRCT) are a popular and common design option for trials based in primary care. Because the number of eligible patients are limited within each primary care facility, to collect a large enough sample it becomes necessary to involve multiple health care providers from multiple health care clinics. This raises the question … [Read more...]

Creating an assessment tool to improve osteoarthritis knee pain treatment

The knee is one of the joints most commonly affected by osteoarthritis (OA), and pain is the most commonly reported symptom. In England, 1 in 4 individuals aged 55 or over report knee pain, which is often linked to osteoarthritis (OA)[1]. In individuals with OA-related knee pain, mechanisms within the central nervous system (brain or spinal cord), … [Read more...]

Pain after cancer. Let’s take it on.

Here’s an observation of two very different research fields: cancer and pain science education. Take cancer - truly gobsmacking investment in research and treatment globally has seen remarkable improvements in outcomes. Based on UK data, survival rates have doubled since 1970 and for some common cancers, they have quadrupled or more. Now take pain … [Read more...]

Pain sensitivity in migraine: specific alterations related to stimulus parameters and location

Migraine is the second most prevalent neurological disorder [1] with prevalence of 11-23% worldwide  [2-6]. Understanding the mechanisms of migraine may be the key to identifying and developing new treatments. Quantitative sensory testing (QST) methods are established techniques to assess and measure pain sensitivity in order to gain insight into … [Read more...]

I can avoid pain, therefore I must be afraid!

Why is it that some people develop chronic pain after recovering from an injury, while others don’t? Suppose you are one of the many people who had an injury. Let us further assume that you were the one in five who develops chronic pain after injury. You might misinterpret the pain (e.g., you thought that the pain you were feeling was an indication … [Read more...]

2018 EPIC Scholarship Results!

In it’s third year, the EPIC scholarship continues the tradition of helping keen people get to an international conference.  This year we opened it to any international conference – and had so many great applications that it took us two sittings to review them all!  We are happy to be able to help two professionals who both have goals to bring … [Read more...]

Injustice Perception in Chronic Pain: Shaped Through Expectation and Experience

A tendency to perceive pain as an irreparable or unjust experience may vary widely between people and across situations. Sullivan and colleagues have termed this pattern of thinking “injustice perception”, and have proposed that it is comprised of two, related ways of viewing pain: perceiving inequity or unfairness inherent within the experience of … [Read more...]

Physiotherapists struggle to identify and deal with psychological factors in chronic low back pain

Psychological factors including catastrophizing, fear of movement and psychological distress are predictors of negative outcomes in patients with chronic low back pain (CLBP).[1] Furthermore, patients with CLBP often have comorbid depressive and anxiety disorders.[2] Healthcare professionals involved in managing CLBP are therefore challenged to … [Read more...]

What about the clinimetric properties of sensorimotor measurement instruments?

That chronic low back pain (CLBP) is associated with functional and structural changes in the central nervous system is difficult to dispute and subject to wide-ranging ongoing research (Moseley and Flor, 2012, Omori et al., 2013, Vrana et al., 2016),  especially in the field of neuroimaging and neurophysiology (Henry et al., 2011). There are many … [Read more...]