First Year Success for the Local Pain Educator Program

After our 2018 Rural Outreach Tour from Sydney to Albury, Lorimer and the Pain Revolution crew put their heads together to work out a vision that would inspire the organisation to grow over the coming years. It's a huge ambitious vision; ALL Australians will have access to the knowledge, skills and local support to prevent and overcome … [Read more...]

Patient education: panacea, public relations, or path to better care for patients with low back pain?

Part 2 What should patient education involve? Clinical guidelines provide little detail on the what, where, and how long of patient education. There are common features on what should be included: advice to stay active, reassuring of a good prognosis, nothing seriously wrong. Unfortunately, there isn’t much more than that. We don’t, for example, … [Read more...]

Patient education: panacea, public relations, or path to better care for patients with low back pain?

Part 1 Should patient education be part of my treatment? Patient education gets physiotherapists so worked up! I am often surprised at how virulent discussions of patient education can become. “Nocebo language”—language that worsens pain– seems to be a major concern. “Words can harm!” Did you just use a pathoanatomic label for non-specific low … [Read more...]

Arts workshops as a space for pain communication

The second part  of the Communicating Chronic Pain project involved a series of arts workshops undertaken with participants with pain, their carers and interested clinicians [1] (for the first part go here). Qualitative research on pain experience has largely been based on interviews, and frequently emphasises that it is an isolating experience … [Read more...]

Talking the talk: starting the conversation

As physios we spend much of the working day talking with patients (and colleagues!) and consider it one of our core skills, whatever field we work in. These interactions are unique and personal, and have the ability to make or break the outcome of any and every treatment.  If communication is the most important skill that health professionals have … [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...]

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...]

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...]