It’s time for a shake up: Driving system wide change to improve musculoskeletal pain care and outcomes

Shaking it up Most of us working in the pain field know the many challenges well. Challenges are widespread, reaching from the health systems (macro) level, downstream through service delivery level and into the clinical (micro) coalface. How can we approach this complexity to achieve person-centred care and respond to the escalating burden … [Read more...]

Self-efficacy and paradoxical dependence in chronic back pain

Chronic back pain is one of the most common medical problems patients experience, and it may also be psychologically and socially disabling. People with chronic back pain are significantly more likely to experience depression, anxiety, and other mental health conditions than the general population. I wanted to get a deeper appreciation of how … [Read more...]

Pain? Where?! Attentional bias for pain in the brain

Shortly after starting my PhD, my father had a work accident. He broke his wrist in 2 places, and after surgery had to undergo weeks of physiotherapy. While I do not particularly enjoy seeing others in pain, I must say that, as an experimental psychologist, his timing could not have been better. Indeed, his accident proved to be the perfect … [Read more...]

Unravelling Fibromyalgia

Oh for the dream of precision medicine in the world of fibromyalgia (FM)! But how can one possibly apply precision medicine to a condition with the character of a chameleon? Why do we say FM is like a chameleon? The suffering experienced by persons with FM is camouflaged by an outside appearance of normalcy, and the symptoms of FM come and go … [Read more...]

Implementation science and its use in low back pain research

The implementation of evidence into practice, even today, where science plays a role in much of our lives, is an elusive task. This challenge in health care is perhaps most vividly demonstrated in the back pain field, where numerous studies show that evidence-practice gaps haven’t improved over the last two decades or more.  Implementation science … [Read more...]

Treating the Emotional Problems Underling Centralized Pain

Chronic pain and emotions are closely tied. Not only is chronic pain linked to changes in depression, anxiety, and anger, but emotions also impact pain [1]. Some types of pain appear to be particularly influenced by emotional processes. Fibromyalgia, irritable bowel syndrome, pelvic pain, temporomandibular joint pain, headaches, and many cases of a … [Read more...]

The causes and mechanisms of back pain

For some time, patients, clinicians and researchers have tried to understand the causes of back pain. Theories are abundant, and some have been empirically tested. But to date, the only thing clear is that we’re still unsure about what causes back pain. This uncertainty about the causes and mechanisms of back pain stifles the development of … [Read more...]

LBP in children and adolescents

Is back pain a problem for kids? One of the things that some universities do to help out new researchers is have senior academics look over their grant applications before they are submitted. Recently we had a proposal for a study on back pain in adolescents assessed in this way. One of the comments was that back pain is not a problem for … [Read more...]

Core outcome measures for low back pain

The use of different outcomes across clinical trials on the same health condition may hamper comparability of findings and conduction of meta-analysis. This problem can be dealt with the development of a core set of outcome domains and measures. A core outcome domain is an aspect of health that should be measured and reported in every single trial … [Read more...]

Self-management and behaviour change in persistent LBP: Where is the science currently at?

Background Typically, self-management behaviour change interventions for persistent low back pain (LBP) help the patient to learn and adopt a set of health behaviours that they can use to reduce or manage their symptoms. Although this may seem like a core part of treatment, the effectiveness of self-management interventions for persistent LBP to … [Read more...]