A misty, multidimensional crystal ball

Wouldn’t it be great if we could give our patients a prognosis that is evidence based and tailored to their presentation? Chronic low back pain (CLBP) is, however, a complex multidimensional problem, and over 200 factors (from multiple dimensions such as demographics, psychological, social, health and lifestyle etc.) may be prognostic for people … [Read more...]

Can we train pain-related attention?

Spoiler alert: This blogpost contains null findings.  Paying too much attention to pain is bad. At least, that’s the idea for people who have chronic benign pain, where the pain no longer provides much useful information about the state of the body. People with chronic pain often report being frequently interrupted by pain, meaning that they’re … [Read more...]

Are people who practice yoga better at motor imagery?

Yoga has been practiced around the world for thousands of years and usually involves a series of integrated mind-body exercises – concentrating on stretching, breathing, balance, co-ordination and control. It also involves significant aspects of meditation and relaxation. These days in Western cultures, yoga is often practised within the context of … [Read more...]

When pain kills – chronic pain and chronic diseases

One high profile campaign to raise awareness of persistent pain uses the tagline ‘persistent pain doesn’t kill, but it does ruin lives’. This is a fair argument, but recent data raise the possibility of an increased risk of death from other diseases (e.g. cardiovascular disease, cancer) in people who suffer from chronic pain[1]. We now need to find … [Read more...]

Can preschool-age children reliably report the intensity of their pain?

From infancy onward, mammals express pain by vocalization, body movement, and facial actions. Such expression can communicate danger to others or elicit support. But these observable actions are not always specific to pain, and they diminish as pain persists. In humans, the understanding, prevention, and relief of pain is helped by receptive and … [Read more...]

Quantitative sensory tests: are they stable over time?

We use quantitative sensory testing (QST) to explore how somatosensory information is processed in the nervous system in people with painful conditions such as low back pain, fibromyalgia, and irritable bowel syndrome. QST has shown promise for clinical applications such as evaluating responses to interventions (Grosen, Fischer et al. 2013), … [Read more...]

How does watching a parent in pain impact children’s own pain experiences?

Pain problems tend to run in families; if you have a parent with chronic pain you are also more likely to experience chronic pain yourself 1. While a simple explanation for this phenomenon is that parents and children share genetics that may predispose them to pain, research has shown that this does not fully explain the relationship, and thus begs … [Read more...]

How feeling upset might increase pain after a bad night

Emotions, sleep and pain are interlinked; however, we understand little about how these aspects of our wellbeing are connected. Does a poor night’s sleep make us feel grumpy, which in turn makes our pain worse? Or does feeling sad in the first place make people less likely to recover from a poor night’s sleep and wake up with increased bodily pain? … [Read more...]

What about congenital insensitivity to pain?

We had a question recently from Mensah Y Amedzo who asked: Hi Lorimer, with regards to this statement “nociception is neither sufficient nor necessary for pain” how do you explain the fact that people with Congenital Insensitivity to Pain never experience pain even though other sensations are intact and they obviously have a brain. They don’t … [Read more...]

Pain and the sum of parts: nociceptive integration

The nociceptive system has evolved a range of intriguing characteristics. Spatial summation is one such characteristic, whereby increasing the area of a stimulus, or the distance between multiple stimuli, results in more intense pain—not only a greater area of pain. This befits pains’ protective function, because larger/multi-site injuries are … [Read more...]