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.

Group Cognitive Behavioural Therapy – can we do better?

Cognitive behavioural therapy (CBT), a  management strategy for chronic pain and its consequences [1], is frequently conducted in groups to minimise cost [2] and maximise efficiency. Although clinicians often report knowing when a group will go well or badly based on who is in the group, evidence that group composition can influence outcomes is … [Read more...]

How we walk affects what we remember…?

Let’s say you tell two friends to bring a list of things from the market. The list contains things they like and things they dislike. When you see them walking back, one is walking with a tall posture, slightly bouncy and a good arm swing, while the other is walking slumped, swaying sideways with minimal arm swing. Which one is more likely to have … [Read more...]

Why physical therapy treatments for low back pain may not be living up to their potential

Low back pain (LBP) is a leading contributor to people living with disability throughout the world,1 and the problem appears to be getting worse rather than better.2 Scientists and clinicians, therefore, need to improve treatment for LBP to shift this trend and reduce disability. People with LBP change how they control their posture for … [Read more...]

Diagnostic uncertainty and pain-related guilt: new treatment targets for low back pain?

Low back pain (LBP) is a highly prevalent condition, with a devastating impact on society and it is now recognized as the leading cause of disability worldwide (Lim et al., 2012). Research suggests that several psychological factors play an important role in LBP, and among the most robust factors are depression, catastrophic cognitions, fear of … [Read more...]

Low Back Pain Treatment in Primary Care

In general, most acute low back pain (LBP) recovers spontaneously within a few days or weeks. No active treatment has shown to actually shorten the time it takes for acute back pain to recover. The purpose of medication, manipulation, acupuncture, physiotherapy etc. is at best to ease the pain while one is waiting for nature to heal. And one should … [Read more...]

The enduring bond between chronic back pain and sleep disturbance: not a love story

Intuitively, one expects that pain, whether acute or chronic, will affect sleep quality. However, the relationship between pain and sleep is not fully understood. Pain has been widely reported to be associated with various measures indicative of sleep disturbance including reduced sleep efficacy, reduced total sleep time, delayed sleep onset, … [Read more...]

Placebo responses and central neuropathic pain: from meta- to pooled analysis of clinical trial data

Defined as a reduction in pain without a biologically active therapeutic, the placebo response includes the placebo effect (i.e., psychobiological factors that cause a reduction in rating) in addition to other contributing factors, such as natural and expected fluctuations in pain [4]. To improve the design of future clinical trials, recent work … [Read more...]

Common psychologies in back pain?

Numerous psychological factors are associated with chronic low back pain (CLBP) and disability. Clinically, it would appear that the psychological profiles of individuals with CLBP can be dominated by different psychological factors. For example, some people are significantly depressed while others might exhibit strong fear-avoidance beliefs. In … [Read more...]

When is a Placebo Acceptable in the Clinic?

We recently published a paper with the mouthful title “Placebo Use in Pain Management:  A Mechanism-Based Educational Intervention Enhances Placebo Treatment Acceptability”[4].  Before I get to the the findings from that paper, I’d like to provide some context of where this paper fits in the larger placebo analgesia literature. Placebo is not … [Read more...]

Cognitive Functional Therapy for chronic low back pain: The patients’ perspective

Pain and lack of function are the two main factors that motivate people with non-specific chronic low back pain (CLBP) to seek care [1]. When you ask a person with CLBP what treatments they have tried, the answer is often in the form of a shopping list: manual therapy, stabilising exercises, Pilates, yoga, medication, injections… and so might the … [Read more...]