BodyInMind

BodyInMind looks at the relationship between the body, the brain and the mind and how they interact particularly in chronic and complex pain disorders.

Exercise considerations for chronic musculoskeletal pain

Chronic musculoskeletal pain (CMP) encompasses a diverse range of conditions such as osteoarthritis, discogenic spinal pain, fibromyalgia and chronic widespread pain. There is consistent evidence for the benefit of exercise to improve pain and function in CMP, although there is considerable uncertainty concerning the best exercise modality and … [Read more...]

Assessment of movement control impairments of the neck

In a study on patients with and without neck pain we set out to evaluate a battery of ten movement control tests for the neck using a Rasch analysis (Sattelmayer, Hilfiker, Luomajoki, & Elsig, 2017). The aim was to establish whether all movement control tests measure the construct “movement control impairments of the neck”, to establish the … [Read more...]

Embodied Pain: negotiating action

We determine our world through the actions we take. Whether from the inside or out, our bodies provide us with the means to actively investigate our environment. This investigation is vital to survival. Active investigation enables us to reduce the uncertainty of the world, accommodate the unexpected, and better predict the consequences of our … [Read more...]

Pain after cancer: A new model for pain psychology?

What if every headache, every slight twinge in your back, was potentially life threatening? What if you couldn’t tell a brain tumour from coffee-withdrawal? These can be constant, niggling worries for many people who have survived cancer, and we think their experiences can tell us something important about pain. If you have read a Body in Mind … [Read more...]

Intense pain influences the cortical processing of visual stimuli projected onto the sensitized skin

Imagine that you are cooking, your food in the oven is ready and you want to take it out. Hunger makes you impatient and you put your bare hand into the oven, but you accidentally touch the hot surface. You get a painful burn. The area of the burn becomes and remains more sensitive for a while. If you were to touch or apply a sharp object on that … [Read more...]

Frozen shoulder: fact or fiction?

The term ‘frozen shoulder’ captures the imagination, and carries the implicit suggestion that if frozen it can then thaw. Our paper “Natural history of frozen shoulder: fact or fiction?” published this year in the journal Physiotherapy [1], is a systematic review of the literature regarding the conventional story that a frozen shoulder progresses … [Read more...]

Managing low back pain in secondary care:  Should we screen to target those ‘at risk’ or treat them all?

This study [1] arose out of a clinical aspiration to do things better.  Daily practice in secondary care spinal clinics at a large metropolitan hospital saw distressed and disabled patients with low back pain (LBP) come and go.  Many had waited months or years for ‘surgical’ consultation, only to be promptly discharged – with “community-based … [Read more...]

Clinical prediction rules: Use the babies and throw the bathwater?

There are easily a thousand clinical prediction rules (CPRs) related to managing musculoskeletal pain. Okay, maybe a thousand is an exaggeration. My point is there are many. All designed with the aim of helping clinicians to make more certain decisions about diagnosis (diagnostic CPRs), prognosis (prognostic CPRs) or likely response to an … [Read more...]

Cartographers need not apply: Skin-based maps are self-organising

Many of us will have heard of the visual blind spot, scotomas (an area of partial or complete loss of visual acuity in an otherwise clear field of vision) and phantom limb sensations, but what do these have in common? They show us that despite a void in our perceptual field, we can maintain a somewhat stable perception. Compensation for the missing … [Read more...]

Beyond Balance: outpatient opioid taper without pain increase is possible

Opioid policy debates are often framed in terms of balancing opioid risks with chronic pain relief. This assumes, not only that opioids provide long-term pain relief, but that opioids are necessary for pain relief. Based on our many years’ experience with successful opioid dose reduction in our structured multidisciplinary pain rehabilitation … [Read more...]