Chronic Low Back Pain and Advanced Mathematics

It is tempting, in research, to apply the normal rules of summation - where adding one treatment that you think is effective to another treatment that you think is effective should give you a combined treatment that is more effective than either.  However, as Cormac Ryan from Glasgow Caledonian University points out, it does not necessarily work … [Read more...]

Teaching people about pain – a kind of position paper

Some time ago, I wrote this paper, at the request of the journal Physical Therapy Reviews, on reconceptualising pain. It is a little old now but it has come to be a bit of a position paper. The position has four fundamentals, none of which will be very surprising to anyone I imagine: (i) pain does not provide a measure of the state of the … [Read more...]

What did you expect?

Hands-up who thinks a patient’s expectations influence how well they do in treatment? By Steve Kamper Nearly everyone? That’s no surprise. Research recently published by a group in the US reported on the relationship between expectation and outcome in a sample of back pain patients receiving physiotherapy. This is by no means the first time … [Read more...]

Back Pain Myths Closing Sale Everything must go

Everyone knows all about low back pain. This is probably by virtue of the fact that most of us have or will experience it at some stage. Everyone is an expert, clinicians and patients alike and there are a whole host of accepted truths about back pain that we all cling on to. Ideas that replicate themselves successfully across populations have been … [Read more...]

Exercise and Back Pain – Hell’s own elephant

It’s getting cramped in here and I can’t work out why. I’m inside a room labelled 'how to treat low back pain' and something enormous is taking up all the space. Exercise is at the heart of the physical therapies in the treatment of back pain. Most forms of therapeutic exercise boast arguably plausible theories and don’t require a belief in … [Read more...]

Where is my back?

Chronic pain is associated with a loss of the normal capacity to know where your body is. Chronic pain is also associated with odd bodily feelings. To find out if people with chronic back pain had trouble 'feeling' their back, they were asked to draw on a piece of paper the outline of where they felt their back to be. This is a bit tricky to … [Read more...]

Back pain- Neil OConnell on local muscles going global

We’ve known for a while that people with chronic back pain move differently. Normally when you are going to wave your arm or leg the deep spinal muscles kick in just beforehand, perhaps to provide stability.  In back pain the activity of some of the deep back muscles is delayed in response to spine and limb movements. This has been demonstrated in … [Read more...]