Pain sensitivity in migraine: specific alterations related to stimulus parameters and location

Migraine is the second most prevalent neurological disorder [1] with prevalence of 11-23% worldwide  [2-6]. Understanding the mechanisms of migraine may be the key to identifying and developing new treatments. Quantitative sensory testing (QST) methods are established techniques to assess and measure pain sensitivity in order to gain insight into … [Read more...]

2018 EPIC Scholarship Results!

In it’s third year, the EPIC scholarship continues the tradition of helping keen people get to an international conference.  This year we opened it to any international conference – and had so many great applications that it took us two sittings to review them all!  We are happy to be able to help two professionals who both have goals to bring … [Read more...]

CAUSE FOR CELEBRATION or CONCERN? Thoughts on using left/right judgment tasks in clinical practice.

Introducing left/right judgement tasks (LRJTs) into clinical practice and using them in the management of individuals with chronic pain is, I think, something to celebrate and a success story for translational research. Seminal work on the mental rotation of objects almost 50 years ago (Shepard & Metzler, 1971) led the way for the subsequent … [Read more...]

Pain as a threat to the social self

Times are changing. Our understanding of pain from a purely biomedical perspective has evolved to a biopsychosocial perspective of pain. Intuitively, pain has long been recognized as an experience that can fundamentally threaten our need to feel safe, both physically and psychologically. But what does it mean to say that pain is social? In earlier … [Read more...]

Trigger Points and the Nervous System: Myth or Reality?

There is a worldwide debate about whether trigger points (TrP) can be considered a relevant clinical entity with their own diagnostic criteria,[1] whether TrPs are just sensory and motor phenomena, secondary to other diseases, or whether the TrP phenomena are reliable enough to be meaningfully categorized.[2] The debate extends to the mechanisms … [Read more...]

Acceptance and Commitment Therapy for Prevention of Chronic Pain and Opioid Abuse

Chronic post-surgical pain (CPSP) is a common and debilitating problem that occurs in a significant number of patients following surgery. Orthopedic surgeries are consistently associated with high postoperative pain, with the prevalence of chronic pain at 3–24 months to be 20% or more after Total Knee Arthroplasty (TKA) and 8% or more after Total … [Read more...]

Yelp Offers New Insights into the Pain Management Experiences of Patients and Caregivers

A team of researchers, physicians, and computer scientists at Penn’s Center for Health Care Innovation have explored the various ways in which social media data can be used to investigate some of the most pressing issues in medicine. Some topics investigated include inequality in medical outcomes among different populations, trends among people … [Read more...]

Models of Care In Musculoskeletal Pain Management – Should We Be Learning From The Compensation ‘Comparator’ Group?

Contextual factors play a critical role in musculoskeletal pain[1] and consequently also pain related disability[2]. This is demonstrated powerfully in the compensation arena. The compensable context is associated with comparatively inferior outcomes, including poorer responses to interventions[3-5]. In a circular argument, the context itself is … [Read more...]

Who responds well to psychologically-based treatments for chronic pain?

How do we know whether a patient is likely to do well in the psychologically-based treatment we offer them? The truth is, at least for the moment, we don’t. At least not in any way that is evidence-based or precise. If you work clinically and are anything like me, this might sit rather uncomfortably. I work with patients with chronic pain and … [Read more...]

The STarT Back Tool for people with chronic low back pain – strengths and limitations

The STarT Back Tool (SBT)[1] is a 9-item, self-report questionnaire that includes treatment modifiable domains (spread of pain, disability, and psychological factors).[2] It subgroups patients with non-specific low back pain (LBP) into low, medium, and high risk of future disability with the purpose of matching each subgroup to a care pathway. The … [Read more...]