A Journey to Learn about Pain – a book about pain education for children

Persistent pain in children is an increasingly recognized clinical problem with high prevalence rates found in some populations. A conservative estimate posits that 20% to 35% of children and adolescents are affected by persistent pain worldwide (1). The most commonly reported pain problems in children and adolescents are headache; abdominal pain; … [Read more...]

The disconnect between tissue pathology, load and pain: implications for clinicians

For at least two decades, we have known that for chronic pain conditions there is discrepancy between tissue damage seen on clinical imaging and clinical presentation. You can have a severely osteoarthritic X-ray with no pain, or a completely normal X-ray with severe pain. Despite this disparity, imaging findings, such as meniscal tears, rotator … [Read more...]

How does prolonged experimental back pain alter measures of pain inhibition and facilitation?

Facilitation of central pain mechanisms is proposed to be a potential missing link between identifiable tissue damage and the severity of pain experienced across a range of painful conditions [1]. Clinically, it is purported to manifest as widespread hyperalgesia, due to impaired descending nociceptive inhibition and enhanced nociceptive … [Read more...]

Can we learn to feel tired?

At BiM, we have often discussed the idea that learning processes might contribute to chronic pain (e.g., 1, 2, 3, 4). Researchers are also investigating whether other unpleasant states, such as fatigue, can be learned. For this reason we have invited researcher and psychologist Bert to tell us about his work. It is normal to feel tired after a … [Read more...]

Left right judgement task performance – more than the body schema

Sometimes very simple tasks are more complicated than we imagine.  An example is the Left Right Judgement Task (LRJT). In this task individuals are shown images of body parts and they must decide if the image is of the left or right side of the body (or if it is turned to the left or right for the low back and neck). Often individuals with … [Read more...]

Is chronic widespread pain passed down from parents to children? 

Nearly everyone experiences pain that is felt in the bones, joints, muscles, tendons, or ligaments at some point – commonly termed ‘musculoskeletal pain’. For example, 80-90% of people experience low back pain at some point in their life, with approximately one in three reporting chronic (or long-lasting) symptoms [1]. Chronic musculoskeletal … [Read more...]

Do people with chronic pain have altered motor imagery?

The left/right judgement task (LRJT) is a common method of assessing motor imagery performance. The LRJT  involves viewing images of a hand or foot [1], for example, and determining whether the image belongs to the left or right side of the body. This determination is done implicitly meaning that we make an initial judgement then mentally position … [Read more...]

Should I stay or should I go? When goals conflict in the context of pain

Why is it that some individuals with chronic pain stay fairly active, and others are not? Why do individuals act the way they do? One possible answer to both questions might be motivation. Imagine being an individual suffering from chronic pain. When you experience pain, it may push you to pursue or avoid activities in order to control pain or … [Read more...]

Prickly issues: The biopsychosociality of pain might not necessarily mean biopsychosocial treatments work. 

A little while ago now*, O’Keeffe et al published a systematic review and meta-analysis that showed little difference in effect between treatments they described as physical, psychological or combined. The paper was vigorously criticised by Robert Gatchel—of functional restoration fame—and John Licciardone, who run a combined all-on-one-site … [Read more...]

Lifestyle behaviour change with chronic pain isn’t a piece of cake

Chronic pain and other chronic health issues appear to have considerable links. For example, data published by the Australia Institute of Health and Welfare show 64.5% of people with chronic back problems also report another chronic condition, such as cardiovascular disease, diabetes, chronic obstructive pulmonary disease. One hypothesis for why … [Read more...]