Editors picks: Pain as a threat to the social self

Over this holiday season we are publishing our Editor’s picks of 2018 for you to read and enjoy again. The second one is by Kai Karos. -- 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 … [Read more...]

Editors picks: Lifestyle behaviour change with chronic pain isn’t a piece of cake

Over this holiday season we are publishing our Editor’s picks of 2018 for you to read and enjoy again. The first one by Amanda Williams and Chris Williams -- Chronic pain and other chronic health issues appear to have considerable links. For example, data published by the Australia Institute of Health and Welfare show 64.5% of people with … [Read more...]

Search for the Holy Grail for Preventative Analgesia

The opioid epidemic is the largest public health issue facing the United States, and we are at a critical crossroads as pain physicians to find effective alternative medications and approaches for chronic pain. This sharp swing away from opioid prescription has left many patients in the US feeling desperate and helpless. The need for alternative … [Read more...]

Gender and pain: thinking beyond sex differences

Consider the following… What is the first question that comes to mind when you find out someone is pregnant? Most of us would ask “Is it a boy or a girl?” As humans, knowing whether someone is male or female is a part of how we organize information about them in our minds. Just knowing this one simple fact allows us to access a huge arsenal … [Read more...]

Patient education: panacea, public relations, or path to better care for patients with low back pain?

Part 2 What should patient education involve? Clinical guidelines provide little detail on the what, where, and how long of patient education. There are common features on what should be included: advice to stay active, reassuring of a good prognosis, nothing seriously wrong. Unfortunately, there isn’t much more than that. We don’t, for example, … [Read more...]

Patient education: panacea, public relations, or path to better care for patients with low back pain?

Part 1 Should patient education be part of my treatment? Patient education gets physiotherapists so worked up! I am often surprised at how virulent discussions of patient education can become. “Nocebo language”—language that worsens pain– seems to be a major concern. “Words can harm!” Did you just use a pathoanatomic label for non-specific low … [Read more...]

Explaining Pain for Acute Back Pain – reflections on Traeger et al. part 2

4. Why am I excited? First up, one of the great liberators of being a scientist is that we are not just permitted to change our minds, we are actually required to do so when the data say so. The Very Excellent Kevin Vowles uses the phrase ‘dance to the data’ and I like it. So, I have changed my mind about the likely benefit of just adding a two … [Read more...]

Explaining Pain for Acute Back Pain – reflections on Traeger et al. part 1

The PREVENT trial published recently in JAMA Neurology seems to have created a storm. If  views and tweets and general social noise are your metric, then this one weighs in pretty well – over 15K views and altmetric score passing 260 inside a week. But if impact on the community and likelihood to move the field forward is more your thing, then this … [Read more...]

Aerobic exercise and pain perception in people with headache – what’s the latest?

Now the paper is actually called “Has aerobic exercise effect on pain perception in persons with migraine and co-existing tension-type headache and neck pain?  A randomised controlled, clinical trial” and I confess I did have to read the title several times to get my head around it, but I was instantly intrigued. What do we know about this? There … [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...]