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...]

“We should have listened to Brian!” Or “The Python’s knew all along”.

For decades we have known that treatment outcomes for people with low back pain have been suboptimal. The research community has been trying to determine subgroups, based upon key individual characteristics, amongst those with low back pain. The aim behind such subgroup-based approaches is that clinicians can identify which subgroups patients are … [Read more...]

Response to the blog ‘Brain-targeted treatment in people with painful knee osteoarthritis in tertiary care: was it feasible?’

This is a very good summary and commentary regarding the osteoarthritis (OA) and brain training research project [1] that dominated several years of my life. I work full-time as a clinician in the Osteoarthritis Hip and Knee Service (OAHKS) of Northern Health in Melbourne; hence I assess about 20 people each week with varying degrees of OA … [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...]

The Pharmacologic Treatment of Chronic Pain in Children: Are We Any Better Off Today?

In the last three decades we have witnessed the expansion of the scientific study of pain and its treatment: from bench to bedside, from biology to psychology, the treatment of pain has gone from a discipline based on experience and anecdote to one based on scientific evidence. In the treatment of adults there has been a steady growth in novel … [Read more...]

Adding motor imagery to motor control training can improve neck sensorimotor function

Neck pain is one of the most common musculoskeletal disorders with a global annual prevalence of 37% [1]. People with neck pain show neck-specific motor control dysfunction including impaired proprioception [2] and sensorimotor function, altered movement patterns [3-5], and reduced maximal voluntary isometric contraction of deep cervical muscles … [Read more...]

Treating chronic low back pain: is it as simple as changing a person’s mindset?

Mindset. It’s an interesting, some would say controversial topic. Carol Dweck and colleagues [1] first started investigating school students’ attitudes to failure and were intrigued as to why some students rebounded and others seemed devastated by small setbacks. Following years of research, they created the terms ‘fixed mindset’ and ‘growth … [Read more...]

Development and testing of pain education programme for low back pain in Nepal: The PEN-LBP trial

Similar to developed countries, low back pain (LBP) is the biggest cause of disability in developing countries such as Nepal [1]. Surprisingly, most research on LBP in Nepal has focused on low value care - treatments with questionable effects but often with known risks or side effects and significant costs. As most health expenses in Nepal are … [Read more...]

Acute low back pain: Can screening predict recovery?

There is substantial variability in the clinical course of people presenting with acute low back pain (LBP) – pain that lasts for up to 3 months. The majority of patients with acute LBP recover from the episode within a few weeks or months;[1] however, substantial variability exists between patients: some will recover within a few days, others will … [Read more...]

Seeing your pain site – continued

Some time ago we reported here about the effect of visual induced analgesia on experimental pain in chronic back pain patients. In short to remind you: we used real-time video feedback; a video camera filmed the back and presented the video in real-time on a monitor in front of the subjects, and that was compared to watching a plain hand video. We … [Read more...]