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...]

Who responds well to psychologically-based treatments for chronic pain?

How do we know whether a patient is likely to do well in the psychologically-based treatment we offer them? The truth is, at least for the moment, we don’t. At least not in any way that is evidence-based or precise. If you work clinically and are anything like me, this might sit rather uncomfortably. I work with patients with chronic pain and … [Read more...]

To express or not to express pain? That’s the question

A child falling on the street might seem perfectly fine yet burst into tears upon being noticed by its parents. If your (male) partner has the flu, you will no doubt detect his overt expressions of suffering. As humans, we likely express our pain when we seek understanding or help from others. In extreme cases this might save our lives, so it is … [Read more...]

Designing next-generation psychotherapy in pain

People are often surprised at how badly our treatments for chronic pain perform. Pharmacological, surgical, rehabilitative, and psychological treatments all underperform against our expectations, wishes and ideals (Eccleston and Crombez, 2017). The good news, however, is that there is fervent research activity in the pharmacological and surgical … [Read more...]

Changing pain thresholds with classical conditioning

Our previous post about a classical conditioning model for pain generated some lively discussion.  Some argued vehemently that pain cannot be a classically conditioned response, and others argued vehemently that of course it can and we have known this for decades.  We haven’t yet pinned our colours to any particular mast – we’d like to see the … [Read more...]

Expressing pain: which patients do we trust?

Trustworthiness is one of those instant judgements we automatically make about other people, affecting our behaviour towards them [1]. We wanted to know whether clinicians’ judgements of patients’ trustworthiness affected their estimation of patients’ pain [2]. There seem to be so many grounds on which the complaint and expression of pain is met … [Read more...]

Pain Management – it’s a sham

If we posit that pain is an output of the brain that is based on the perception of threat, it would follow that decreasing threat, whatever it may be, would positively influence a person’s pain experience. This has led to some exciting therapeutic advances aimed at altering threat, which include encouraging patients to rewrite their pain experience … [Read more...]

I can feel your pain so clearly that it makes me trigger my defence mechanisms!

We are very pleased to be hosting Prof Serge Marchand for PainAdelaide 2016. His team recently published an interesting paper and we thought it was a great opportunity for us, and for all those coming to PainAdelaide or subscribing to PainAdelaide at your place (click here to buy a pass), to get a quick window into his work.   The mere … [Read more...]

Suffering from pain is optional: Pain catastrophizing and your brain

Experts agree that the experience of pain is influenced by a large number of biological, social, and psychological factors.  The state of our physical body, the amount and quality of support we get from our family and friends, and our beliefs about pain all work together to influence the intensity and quality of all of our sensations, including … [Read more...]

50 shades of touch: the relationship between pleasure and pain

Pain is usually such a negative experience that we rarely think about it in terms of just another sensory modality let alone consider the potential of positive aspects to it. Because of that, this post will be a bit unconventional, especially for a BiM blog. My post, somehow inspired by the controversial novel and movie, “50 shades of Grey”, is … [Read more...]