Woolly Undercrackers! For chronic back pain! This seasons methylene blue?

Keeping up to date in chronic back pain research is a busy process and yet it is rare that a new paper really catches the eye. A while back a trial of methylene blue injections appeared to demonstrate surprisingly impressive results. I blogged on it (here) and mused on how results that good really need to be independently replicated before we can … [Read more...]

Exercise for chronic back pain: The beige trouser effect?

Most commonly used exercise therapies for back pain are aimed at having an effect on some mechanical or tissue based aspect of spinal function. From range of motion exercises to muscle balance, endurance or strengthening exercises the (not unreasonable) rationale is that back pain is associated with abnormal spinal function - address that with … [Read more...]

Lumpers, Splitters and STarTers

In recent years there have been many debates about the disappointing results from clinical trials of treatments for non-specific low back pain. One argument has been about the targeting of treatment for back pain. Many folk have argued that trials which apply a one-size-fits-all treatment fail to show a reasonable effect because amongst those who … [Read more...]

There is no such thing as a new idea

For my first BIM post I wanted to blog about an article that I read some years ago that had probably the biggest impact on my thinking on low back pain and disability and 15 years later still informs the way that I think about pain and disability. Around the mid 1990s when I first started research in low back pain a UK-based health psychologist … [Read more...]

From American flags to models of the spine – linking the impossible?

I have just come across an intriguing paper in Psychological Science by Travis Carter and his mates in Chicago.  They did an experiment in which Americans who were filling out political surveys did so with either a small American flag in the corner of the screen, or nothing in the corner of the screen. They analysed the participants’ responses to … [Read more...]

Low back pain research: The vegetarian barbeque?

I’m not a vegetarian. Perhaps that understates the issue, I am a fundamentalist carnivore and the idea of a barbeque without sausages and burgers is to me an unconscionable aberration; an affront to common decency. Just be honest and call it a salad party….and then don’t post my invitation. Just as the missing meat at a barbeque is a matter of … [Read more...]

Promising results from a graded retraining programme in chronic back pain

Reduction in pain and disability with a graded sensorimotor retraining program in chronic back pain Our team recently returned home from Darwin, where we all attended the Australian Pain Society’s Annual Scientific Meeting.  We all presented some of our work up there and had a lot of fun while we were at it.  I presented a poster, based on some … [Read more...]

Subgroups in low back pain – were the assumptions correct?

Quick reminder from last post: The aim of our study[1] was to evaluate the assumptions that were made when translating the individual study criteria[2-6] (eg, all the criteria from the original subgrouping studies) into the classification algorithm. To evaluate the impact of these changes made to the individual study criteria, we recruited 250 … [Read more...]

Maintenance spinal manipulation: The cherry-pickers quandary

The email from the industry was effusive. In a cock-a-hoop, caps lock-happy frenzy it bellowed “ALL MANUAL MEDICINE PROVIDERS SHOULD BE AWARE OF THIS STUDY”. The study in question, soon to be published in the journal “Spine” is a RCT that specifically looks at whether patients with chronic back pain benefit from a sustained period of “maintenance … [Read more...]

Chronic back pain: Behavioural treatments sent to the naughty step?

We have written a fair amount here about back pain. We’ve criticised some of the information patients get, shown how data has undermined many widely held beliefs about back pain (here and here), and acknowledged the rather desperate state of the evidence in terms of treatment efficacy. It is becoming more popular to see back pain as a problem of … [Read more...]