Classification of low back pain. Are we winning?

Martin Rabey

As clinicians we know that no two people with low back pain (LBP) are identical. However, if we looked at a large number of people with LBP, would we be able to see some patterns emerge? Or similarities that could allow us to group these people together based upon some characteristics of their presentations? The idea of classification systems for … [Read more...]

Talking your pain away…

Annett Schirmer

Like other important sensations, pain elicits automatic nonverbal expressions. The functional significance of these expressions has been recognised by Charles Darwin (Darwin, 1872), who dedicated an entire book to them. In this book, he acknowledged that nonverbal expressions serve as signals for interaction partners. However, he also argued that … [Read more...]

Sensory conflicts may increase limb pain in CRPS by activating mechanisms of general facilitation of nociception

Lone Knudsen

I continue to be fascinated by the perplexing symptoms of complex regional pain syndrome (CRPS). CRPS is characterised by the changeable nature of symptoms throughout the day and during the course of the disease, and patients with CRPS often perceive the affected limb as larger than its actual size (Moseley, 2005; Peltz et al., 2011). Patients with … [Read more...]

Pain: It’s not just personal

Kai Karos

Pain can be paradoxical: On the one hand we know that pain is by definition a fundamentally subjective and individual experience. As psychologists we have fought long and hard to change the public and scientific understanding of pain as a purely medical phenomenon towards a biopsychosocial construct. On the other hand we know that pain is not … [Read more...]

What’s the deal with all these screening studies?

Emma Karran

The cost of chronic back pain and the limited resources that we have to deal with it, has led to many studies that attempt to ‘screen’ patients with low back pain in order to target treatment at the patients who need it most. I have had a clinical interest in this idea for some years and have spent the last 12 months with my head buried in the … [Read more...]

Flexibly Parenting Teens with Pain

Wallace, Dustin - UMKC portrait

Although a teenager with chronic pain might never admit it, research has shown that parents influence their pain and functioning even beyond annoying them (and thus “causing” pain). In fact, research shows that many things parents do, or even think, can impact their child’s pain. Unfortunately, most things are not always good or always bad! Pain … [Read more...]

Phantom limb pain: peripheral or central origin?

Martin Diers

In a recent paper by Vaso et al. (2014) it was suggested that phantom limb pain is driven primarily by activity generated within the ectopic dorsal root ganglia (DRG) (they wrote for BiM on it here). Ectopic activity is abnormal spontaneous activity generated in neuromas in the residual limb as well as in dorsal root ganglions. The authors reported … [Read more...]

Multidisciplinary rehabilitation for chronic low back pain

Steve Kamper

It is more or less well-accepted nowadays that back pain, particularly when chronic, is best understood within a biopsychosocial framework. The implication is that treatment is more likely to be successful if it includes components that target not only physical issues but also psychological and/or social factors. This is the premise that underpins … [Read more...]

Non-specific chronic back pain and hyperalgesia – A different story told by laser stimulation

Thomas Weiss

Despite our best scientific endeavors, what actually causes the pain in chronic low back pain (CLBP) often remains unclear. Approximately 85 % of chronic back pain patients are classified as having non-specific low back pain [1] because a definitive diagnosis cannot be given. That is, pain cannot be confidently attributed to known pathoanatomical, … [Read more...]

A novel alternative to conventional pain killers?

Christoph Stein

In a recent clinical study we showed for the first time that a large fraction (about one third) of pain relief produced by morphine (the gold standard among pain killers) is mediated by opioid receptors outside the brain. In patients undergoing knee replacement surgery, the blockade of such peripheral opioid receptors by methylnaltrexone (an opioid … [Read more...]