Core outcome domains for non-specific low back pain

Alessandro Chiarotto

In 1997, during the second International Forum on Primary Care Research for Low Back Pain (LBP) held in The Hague (Netherlands), a group of experienced clinical researchers gathered together and decided to formulate a standardised set of outcomes to be recommended to colleagues for use in LBP clinical research. These recommendations included five … [Read more...]

Self-management for people with back pain and osteoarthritis – reviewing the evidence

Elaine Toomey

Osteoarthritis (OA) and chronic low back pain (CLBP) are two of the most common musculoskeletal pain conditions in the developed world (WHO, 2003). These conditions place a huge burden on both the health system, in terms of service demand, and the people with the condition, in terms of quality of life and personal wellbeing (Buchbinder et al., … [Read more...]

50 shades of touch: the relationship between pleasure and pain

Dr Alberto Gallace

Pain is usually such a negative experience that we rarely think about it in terms of just another sensory modality let alone consider the potential of positive aspects to it. Because of that, this post will be a bit unconventional, especially for a BiM blog. My post, somehow inspired by the controversial novel and movie, “50 shades of Grey”, is … [Read more...]

Sleep, pain and exercise

Helena Hachul

Sleep is an essential biological phenomenon, and sleep deprivation causes various physiologic and behavioral changes in the body. It has been shown that total sleep deprivation (Shuch-Hofer et al., 2013) or sleep deprivation of a specific stage of sleep (Roehrs et a., 2006; Azevedo et al., 2011) cause hyperalgesia (exaggerated sensitivity to pain). … [Read more...]

tDCS for clinical use. Let’s not throw the baby out with the bath water

Asbjørn Fagerlund

In my academically formative years, a psychology text book defined psychology as a scientific discipline that aims to describe, predict and change behavior. This definition stuck. Shortly afterwards, during my training as a clinical psychologist, I was introduced to tDCS by Dr. Per Aslaksen at the University of Tromsø. The method was appealing: a … [Read more...]

The role of sleep impairments on pain severity in adults with sickle cell disease

Gyasi Moscou-Jackson,

Sleep is a complex process and impairments can occur at different stages of the process. Sleep impairments may include decreased total sleep time (sleep duration), an increase in the amount of time it takes to fall asleep (sleep onset latency), or an increase in the amount of wakefulness after sleep onset (sleep fragmentation) experienced by an … [Read more...]

Review of clinical utility of pain classification part 2

Niamh Moloney

Part 2: Evaluating mechanism-based classification algorithms for neuropathic pain in people with non-specific arm pain: How’d they do? Translating knowledge of pain mechanisms into clinical practice is challenging. In our study [6] we examined three recently published classifications for assessing pain [1, 2, 7] (see previous post on BiM for … [Read more...]

Review of clinical utility of pain classification part 1

Niamh Moloney

Part I Mechanisms-based classification of pain: the algorithms Understanding pain mechanisms is high on research agendas, but we’re still struggling translating this into practice. A number of frameworks have been published recently, which outline criteria for assessing dominant pain type in individual patients. These include: Guidelines on … [Read more...]

Sympathetic blocks for complex regional pain syndrome

Based largely on his clinical experience, the founding father of modern pain medicine, John J. Bonica, recommended that complex regional pain syndrome (CRPS) be treated with a series of sympathetic blocks as soon as possible after symptoms develop. Although this sometimes seems to work well, the value of this approach has been questioned because of … [Read more...]

Predicting persistent pain after shoulder surgery

Steven George

The goal of our study published in PAIN (January 2015) was to identify risk subgroups for predicting post-operative pain outcomes following shoulder arthroscopy. Our subgroups were made up of genetic and psychological factors believed to be players in the transition from acute to chronic pain conditions. We used a parallel cohort design and the … [Read more...]