So long. Fare well! Auf wiedersehen. Goodbye!

Getting the word ‘daft’ published in the BMJ was a highpoint of my career, but signing out of BIM with a lyric from The Sound of Music, may well top it. Yes, we are signing out of After much discussion, some serious number crunching, a couple of negotiations to pass it on gratis, we have decided to stop. At this stage we are going … [Read more...]

How can we assess the intensity of non-painful events as well as painful events?

When I first entered an experimental pain laboratory, I had no idea what to expect. I was a newbie to the BiM lab, and acting as a pilot participant in a colleague’s experiment. My colleague sat me down, attached some electrodes to my arm, and asked me to tell him what I felt on a 0-100 NRS anchored at 0 with ‘no pain’ and 100 with ‘worst pain … [Read more...]

‘I can’t walk with cramp’: supporting people with intermittent claudication to walk

A “walk in the park” is more difficult than it sounds for someone with Peripheral Arterial Disease. This condition, called Intermittent Claudication (IC), is caused by narrowing of the lower-limb arteries which reduces blood flow to the muscles during walking resulting in a cramping leg pain.  People often have to slow or stop walking every few … [Read more...]

Brain-targeted treatment in people with painful knee osteoarthritis in tertiary care: was it feasible?

Knee osteoarthritis (OA) is a complex disorder that commonly results in diminished physical function, poor quality of life, and reduced life expectancy [1]. While several treatments such as exercise therapy [2] (Pilates, strength, flexibility, conditioning training) have been effective at reducing pain in people with knee OA, unfortunately, the … [Read more...]

Pain neuroscience education: Effects on pain and disability in chronic low back pain

Pain neuroscience education (PNE) has changed our practice as clinicians, our knowledge and the way we interact with patients. But does it change short-term or long-term pain and disability in patients with persistent low back pain? Until recently, three systematic reviews had been undertaken to evaluate the effect of PNE in persistent non-specific … [Read more...]

Embedding psychology into physiotherapy for low back pain – why is it so difficult to change our minds?

“The way I look back at physio now, was that it was just the hell I had to go through in order to eventually get to pain services”. Those were the words a patient with chronic low back pain (LBP) used to describe their experience of musculoskeletal physiotherapy in a patient involvement group I’d been invited to speak at. I was stunned. As a … [Read more...]

Can we use mobile devices for left/right judgement tasks?

The left/right judgment task (LRJT)[1] is enjoying popularity in clinical practices to assess and manage people with persistent pain. The LRJT has compelling theoretical underpinnings that have been tested in many painful [e.g. 2-5] and some non-painful conditions [e.g. 6-8]. LRJT software was initially created to be used on desktop computers, … [Read more...]

What does high value care for musculoskeletal pain look like?

A middle aged patient with slow onset shoulder pain was concerned about the results of a left shoulder ultrasound that showed a partial tear in her rotator cuff. Since the result she had taken to wearing a sling to protect the shoulder from “further tearing”. A patient with a three year history of work related, disabling low back pain, and a … [Read more...]

Breaking it, Faking it and Making it to the World Championships

Dan Van Der Laan has been a trusted Ride Guide and supporter of Pain Revolution for the past two Rural Outreach Tours.  Here is his story: Ever since I was a kid two things have been true. I have loved sport and competition and I have had an uncanny ability to get injured. These things remain. I need a competitive outlet and I have visited … [Read more...]

Poor functional outcomes in pediatric chronic pain – what’s catastrophizing got to do with it?

Catastrophizing has long been implicated in many poor outcomes in chronic pain-related conditions in both adults and children [3,4,11,12,14,15,18,20,22,24,29]. Scholars have called for interventions to reduce catastrophizing in children with chronic pain with the hope of improving outcomes [1,16,36]. However, important unanswered questions remain … [Read more...]