Do brain changes really contribute to persistent low back pain?

If you’ve recently attended a pain conference, had a glass of wine with a pain boffin or spent time googling ‘pain’ you’ve no doubt come across the terms ‘neuroplasticity’ and ‘central sensitization’. These buzzwords are increasingly used to describe biological changes that might contribute to persistent low back pain. But do they really explain … [Read more...]

Medical exercise therapy breaks the chronic pain cycle, even in the longer term, in patients with persistent anterior knee pain

Fig 2

In general there is a lack of long-term success in treating people with persistent musculoskeletal pain and long-term anterior knee pain or patellofemoral pain syndrome (PFPS), is no exception [1].  It is reported that approximately 25% of patients with PFPS continue to have pain and dysfunction one year or more after physiotherapy, the most … [Read more...]

Affective Touch by Others Determines how we Perceive our Own Body

Katerina Fotopoulou

Just why does the touch of a loved one feel so good? The answer may have something to do with the fact that slow, gentle touches from another person (like the caress of a loved one) can enhance our sense of self – specifically, the feeling that our body is our own (i.e. the sense of body ownership). This sense of body ownership seems indubitable; … [Read more...]

Dying values? Does pain matter?

Many established values of palliative care practice (like symptom relief, truth-telling, alleviation of suffering) are based on research done outside of Africa, yet African patients may have different values when it comes to death and dying.  A group of South African researchers sought to find out what processes Xhosa people (a 7.9 million-strong … [Read more...]

We all know that falling over hurts, but can pain come before a fall?

Brendon Stubbs

We have all fallen over, haven’t we? Well you know that it hurts, and you can imagine this is also the case for those of an older age with an increased risk for falls. But how about vice versa? Is pain itself a risk factor for falls in this older group?  This is important as preventing falls is a serious public health issue since fall related … [Read more...]

Subgrouping patients with chronic whiplash on the basis of symptoms of sensory hypersensitivity and PTSD

Ash Pedler

A significant proportion of people (up to 50%) who develop neck pain following a car accident continue to report neck pain at long term follow up. It's not clear why these patients don't recover and unfortunately current evidence seems to indicate that usual rehabilitative management is not very effective for patients with chronic whiplash. The … [Read more...]

Motor dysfunction in Complex Regional Pain Syndrome is related to proprioceptive deficits

Imagine that you want to grab a cup of coffee. Successful planning and execution of this and many other everyday life tasks crucially depends on a good sense of the position and movements of your body parts (= proprioception). Such tasks would be very difficult to perform if you have no (or perhaps the wrong) idea of where your hand is, or what it … [Read more...]

Preoperative Neuroscience Education for Lumbar Radiculopathy

Adriaan Louw

Another in our 'getting your thesis out there' series.  This one from Adriaan Louw, PT, PhD. Congrats Adriaan on finishing your thesis! Background: On average one in three patients following lumbar surgery (LS) for radiculopathy experience persistent pain and disability following surgery. No perioperative treatments have shown any ability to … [Read more...]

Should we train deep trunk muscles to improve the clinical outcomes of low back pain?

Transversus abdominis (TrA) and lumbar multifidus (LM) are two deep trunk muscles implicated in maintaining spinal stability at rest and during physiological movements. A number of research studies have found that people with acute, chronic or recurrent low back pain (LBP) show abnormal changes in the physical characteristics (e.g. shape, … [Read more...]

The fascia and back pain – What does a chemical stimulation tell us about it?

Andreas Schilder

Back pain is a worldwide problem causing time lost from work, disability and economic cost. Over 75% of humans suffer from back pain at least once in their lifetime and the yearly prevalence of the working population is 8%, where the lower back represents the most mentioned region. Disorders of osseous structures, disc herniations or nerve root … [Read more...]