Placebo 101. In three minutes.

Occasionally, very occasionally, Heidi will show me something on youtube (or one of those Heidi-type sites) that is really very good. And this really is very good. The graphics are superb. The coverage of material is excellent. It is faithful to the evidence. It is engaging and it is narrated by an Australian.  These are all, in my view, excellent … [Read more...]

Acupuncture, some dodgy maths and a cracking review paper

I have a challenge for you. Imagine you’re in ancient China and you’ve had this idea that health and disease hang on the flow of energy through invisible energy pathways called meridians that can be manipulated by applying needles in certain specific points. How do you go about systematically validating this theory? How do you know where the points … [Read more...]

Placebo effect: now we can see it, but should we believe it?

Placebo effects are a great way to start a conversation, particularly if one is at a Clinical Trials Festival. Rather than being fascinated by the possibilities of the brain's internal capacities to influence its own outputs, some believe placebo effects are a nuisance and something to either ignored or removed. Well, as you will see from this … [Read more...]

Belgium – Famous for Chocolate and Explaining Pain Biology

Not an immediately obvious pairing, but still a bit more logical than a shop I once visited in UlaanBataar that sold saucepans, fur coats and guns (actually now that I think about it - one could shoot the elk, skin it and cook it up - quite the sensible shop after all). These Belgians have taken on the explaining pain thing and done some very nice … [Read more...]

Teaching people about pain – a kind of position paper

Some time ago, I wrote this paper, at the request of the journal Physical Therapy Reviews, on reconceptualising pain. It is a little old now but it has come to be a bit of a position paper. The position has four fundamentals, none of which will be very surprising to anyone I imagine: (i) pain does not provide a measure of the state of the … [Read more...]

Anxiety and mood in people with fibromyalgia or neuropathic pain – different mechanisms

Professor Troels Jensen's clever group of researchers have published an interesting paper in the European Journal of Pain.  We were thinking about writing a little spiel on it so you can get the idea and then we thought - what about asking the authors? So we did. Fortunately for us, Lise Gormsen, who has now got her PhD via this work, kindly agreed … [Read more...]

Is CRPS an auto-immune disease

Intravenous Immunoglobulin in Complex Regional Pain Syndrome Andreas Goebel on the results of his latest clinical trial .Just imagine the causes of some chronic pains are completely different from what you had thought. Complex Regional Pain Syndrome is a severe pain which persists after limb trauma. You are unlucky if you develop this nasty … [Read more...]

When showing it doesn’t work doesn’t work

I went to Melbourne on the weekend.  To break the time-honoured Moseley tradition of not working on weekends requires some convincing and I was convinced by the nature of the crowd - truly interdisciplinary - and the proximity of venue - a mere 1000 km away.  I went to two talks, so I could get back home in time for Chapter 6 of Rowan of Rin. Of … [Read more...]

The morality of magic kisses: Ethics and placebo in physiotherapy

When my daughter hurts herself, her placebo of choice is a “magic kiss”. This therapeutic intervention must be applied with care specific to the area of injury. Anecdotal evidence suggests that it is very effective. I use placebo freely at home but is it right to do this in the clinic? In a recent post I suggested that we can be more confident that … [Read more...]

What did you expect?

Hands-up who thinks a patient’s expectations influence how well they do in treatment? By Steve Kamper Nearly everyone? That’s no surprise. Research recently published by a group in the US reported on the relationship between expectation and outcome in a sample of back pain patients receiving physiotherapy. This is by no means the first time … [Read more...]