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.

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...]

Can fear of movement lead to physical inactivity in low back pain?

It’s well known for most health professionals who regularly treat patients with back pain that often patients are afraid of moving because they believe that movement will cause further pain and injury. This fear of movement, and belief that physical activities will cause (re)injury, is the central concept of the well-known Fear-Avoidance Model. … [Read more...]

Pain, Disparities, and the Perils of the Endless Loop

“I can’t stop thinking about how much it hurts!” “I’m scared the pain will get worse!” “There’s nothing I can do to make it better!” These and related expressions may ring familiar to pain sufferers – their friends, family, and clinicians too. They are 3 of the many examples of catastrophic reactions that often occur around pain. More … [Read more...]

Tactile acuity in acute pain: do we not see the wood for the trees?

It is well known that chronic pain is associated with changes in the brain: Several lines of research confirm alterations in the central nervous system in chronic pain syndromes including phantom limb pain, complex regional pain syndrome, patients with fibromyalgia, osteoarthritis and - the most prevalent syndrome - chronic non-specific low back … [Read more...]