Some good news for America’s Back Pain Problem?

A couple of weeks ago, I had a mock interview for a new research fellowship with our national research council. In my rather sheltered life, these interviews are a rather big deal – whether or not I am to remain a government-funded medical researcher hangs on the line and the chances are intimidatingly thin. The mock interview then, aims to give … [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...]

The Challenges of Translational Pain Research

Over the past ten years a number of articles have been written detailing the success of researchers in understanding the neurobiology of pain. Over this same period, however, little progress has been made in the development of new long-term interventions for the treatment of chronic pain. Perhaps the most compelling commentary on this topic is the … [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...]

Does early stress or adversity increase the likelihood of chronic pain for kids?

The short answer is “it’s unclear”; but as a pediatric pain psychologist and researcher at Boston Children’s Hospital (Boston, MA, USA), I am currently looking to increase our understanding of this relationship. Historically, going through certain stressful experiences in childhood (also known as Adverse Childhood Experiences [ACEs]; abuse, … [Read more...]

Upper extremity exercise in people with Rheumatoid Arthritis – does EXTRA help?

It is well known that exercise is good for health and wellbeing - but is it OK to exercise if you have painful joints caused by an inflammatory arthritic condition? This is a question that concerns many people with Rheumatoid Arthritis. Rheumatoid Arthritis affects about 0.5% population globally and, although advances in drug treatment have … [Read more...]

Better than what? Any treatment for back pain can be effective… it might just depend on what you compare it with

Was my treatment helpful, benign or harmful? Consider the common clinical scenario – a patient presents complaining of pain. You decide to administer a particular treatment. Over time the patient’s symptoms improve. Do you then succumb to bias and presume your intervention facilitated their recovery? Do you consider the possibility that recovery … [Read more...]

It’s time for a shake up: Driving system wide change to improve musculoskeletal pain care and outcomes

Shaking it up Most of us working in the pain field know the many challenges well. Challenges are widespread, reaching from the health systems (macro) level, downstream through service delivery level and into the clinical (micro) coalface. How can we approach this complexity to achieve person-centred care and respond to the escalating burden … [Read more...]