Development and testing of pain education programme for low back pain in Nepal: The PEN-LBP trial

Similar to developed countries, low back pain (LBP) is the biggest cause of disability in developing countries such as Nepal [1]. Surprisingly, most research on LBP in Nepal has focused on low value care - treatments with questionable effects but often with known risks or side effects and significant costs. As most health expenses in Nepal are … [Read more...]

Pain neuroscience education: Effects on pain and disability in chronic low back pain

Pain neuroscience education (PNE) has changed our practice as clinicians, our knowledge and the way we interact with patients. But does it change short-term or long-term pain and disability in patients with persistent low back pain? Until recently, three systematic reviews had been undertaken to evaluate the effect of PNE in persistent non-specific … [Read more...]

What does high value care for musculoskeletal pain look like?

A middle aged patient with slow onset shoulder pain was concerned about the results of a left shoulder ultrasound that showed a partial tear in her rotator cuff. Since the result she had taken to wearing a sling to protect the shoulder from “further tearing”. A patient with a three year history of work related, disabling low back pain, and a … [Read more...]

Talking the talk: starting the conversation

As physios we spend much of the working day talking with patients (and colleagues!) and consider it one of our core skills, whatever field we work in. These interactions are unique and personal, and have the ability to make or break the outcome of any and every treatment.  If communication is the most important skill that health professionals have … [Read more...]

Pain catastrophising: How can we best deal with it?

Jack: “Ouch, my head hurts!” Jill: “Don’t freak out, Jack.” Jack: “Why not? It hurts!” Jill: “Yeah but freaking out will only make it worse.” Jack: “How do you know? It might make it better.” Jill: “I’ve read the science, Jack. I know. Just take a few breaths. Come on, let’s walk over to that tap and fill up your bucket.” Jack: … [Read more...]

It’s nearly time for APS NZPS 2018 !

Do you like pain research? Do you want to know more about new advances in pain science? Of course you do! You are reading this blog after all!! We wanted to give you a head’s up on a great upcoming pain science meeting - the 2018 Australian Pain Society 38th and New Zealand Pain Society Conjoint Annual Scientific Meeting (APS NZPS 2018). This … [Read more...]

Pain education enhances the pain-relieving effect of exercise in healthy adults

Exercise may be one of the most universally beneficial interventions for people with chronic pain. Despite this, many patients with chronic pain avoid exercise because it can worsen their pain. These contrasting effects show that exercise does have the capacity to influence pain, for better or for worse, but the mechanisms of how exercise does this … [Read more...]

Spreading Pain Education in Brazil

Development of the first internet-delivery pain education intervention in Brazil It is well established that pain, especially chronic pain, is a public health problem worldwide. Chronification of pain may be due to mismanagement of acute pain that can result in modifications in the peripheral and central nervous systems. Likewise, insufficient … [Read more...]

“Encontros Saúde & Dor” Bringing Pain Education to Low-Income Communities in Brazil

Approximately 11.25 million Brazilians live in low-income communities or “favelas.” In my home town of Jundiaí, near São Paulo, there are no less than 14 of these low-income communities, the largest of which houses approximately 15 000 families. Some low-income communities, such as Rocinha in Rio de Janeiro, are home to up to 180 000 people. At … [Read more...]

The false promises of shared decision making in rehabilitation

In the recent years, Shared Decision Making (SDM) has been increasingly advocated as an ideal model of treatment decision-making during the medical encounter, as it has been shown to increase benefits for both clinicians and the health-care system (1).  But does SDM result in better outcomes for patients with painful musculoskeletal conditions?  In … [Read more...]