Injustice Perception in Chronic Pain: Shaped Through Expectation and Experience

A tendency to perceive pain as an irreparable or unjust experience may vary widely between people and across situations. Sullivan and colleagues have termed this pattern of thinking “injustice perception”, and have proposed that it is comprised of two, related ways of viewing pain: perceiving inequity or unfairness inherent within the experience of … [Read more...]

Physiotherapists struggle to identify and deal with psychological factors in chronic low back pain

Psychological factors including catastrophizing, fear of movement and psychological distress are predictors of negative outcomes in patients with chronic low back pain (CLBP).[1] Furthermore, patients with CLBP often have comorbid depressive and anxiety disorders.[2] Healthcare professionals involved in managing CLBP are therefore challenged to … [Read more...]

What about the clinimetric properties of sensorimotor measurement instruments?

That chronic low back pain (CLBP) is associated with functional and structural changes in the central nervous system is difficult to dispute and subject to wide-ranging ongoing research (Moseley and Flor, 2012, Omori et al., 2013, Vrana et al., 2016),  especially in the field of neuroimaging and neurophysiology (Henry et al., 2011). There are many … [Read more...]

Cognitive Biases and Young People’s Pain Experiences: What do we know and where to go next?

Many children and teenagers are affected by chronic pain, which can negatively impact their day-to-day activities, how they feel, and their likelihood of future health problems[1,2,3,4]. Psychological therapies are effective at treating pain and related disability across pain conditions in young people, but there is lots of room for improving their … [Read more...]

The pediatric pain equation: Where do parental injustice appraisals of pain fit in?

Pain is not a singular physical sensation. It can be amplified or reduced by a multitude of physical, psychological, and social factors. For example, we recently found that when children view their pain as “unfair” or “unjust” (pain-related injustice appraisals) they also report more pain, impairment, and worse functioning, even after we accounted … [Read more...]

Pain as a threat to the social self

Times are changing. Our understanding of pain from a purely biomedical perspective has evolved to a biopsychosocial perspective of pain. Intuitively, pain has long been recognized as an experience that can fundamentally threaten our need to feel safe, both physically and psychologically. But what does it mean to say that pain is social? In earlier … [Read more...]

Tilting at Trigger Points

In the recent blog post some may feel it is remiss of Fernández-de-las-Peñas not to have at least considered the possibility that the clinical phenomena attributed to the so-called latent TrP (trigger point) could also be explained as arising from sensitised peripheral neural tissue. This concept was suggested nearly 25 years ago [1] and again more … [Read more...]

Trigger Points and the Nervous System: Myth or Reality?

There is a worldwide debate about whether trigger points (TrP) can be considered a relevant clinical entity with their own diagnostic criteria,[1] whether TrPs are just sensory and motor phenomena, secondary to other diseases, or whether the TrP phenomena are reliable enough to be meaningfully categorized.[2] The debate extends to the mechanisms … [Read more...]

How do pain and working memory interact? Can we decrease pain by improving working memory?

One of the main questions for us as pain researchers is how we can reduce pain.  We already know that painful stimuli such as electrical shocks involuntarily grab our attention because our body prioritizes them to protect us from harmful stimuli. Also, people who have chronic pain pay more attention to painful information and it is possible that … [Read more...]

Two-point discrimination test: the time has come for standardization

As we recently highlighted (see also here and here and M. Catley’s post) tactile acuity assessment has become an increasingly popular area of research in chronic pain. Most two point discrimination (TPD) studies focus on chronic low back pain, but TPD has also been investigated in other conditions that are challenging to treat, e.g. complex … [Read more...]