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...]

Does pain lead to mental illness or is it the other way around?

It’s common knowledge that pain problems and mental illness will affect many of us over the course of our lives [1-4]. Comorbidity between pain and mental illness is often seen in clinical practice and is well established in the literature [5]. But what actually comes first, is it the pain or is it the mental illness? And could it even be that one … [Read more...]

Can video games help older people with back pain?

Low back pain is the leading cause of disability worldwide [1] and up to 90% of people will experience low back pain at some point in their life [2]. The small percentage of people who develop chronic and disabling symptoms account for most of the burden of low back pain, and these are mostly older people [3]. Low back pain becomes more severe … [Read more...]

Search for the Holy Grail for Preventative Analgesia

The opioid epidemic is the largest public health issue facing the United States, and we are at a critical crossroads as pain physicians to find effective alternative medications and approaches for chronic pain. This sharp swing away from opioid prescription has left many patients in the US feeling desperate and helpless. The need for alternative … [Read more...]

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...]