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Perceptual distortions of the body in pain

4 December 2013

…At the Australasian Neuroscience Society meeting in January, [Dr Tasha] Stanton will present her work as part of what promises to be a fascinating session on neuroperception.

“Specifically, I will present the idea that changing how a painful body part looks or feels can actually influence pain levels. I will discuss the background of this work and why we think such a perplexing effect might be happening.”

… Professor Roger Newport from the University of Nottingham in the UK was a pioneer in the concept of illusory modification of the body to influence pain. Recently, he designed a specialised machine called the MIRAGE multi-sensory illusions box, which contains a combination of cameras, mirrors, computers and monitors to deliver a range of illusions.

Subjects insert their painful body part into the machine and can view it in real time. Then the MIRAGE machine is used to alter how the body part looks.

“For instance, someone who has painful hand osteoarthritis can view their hand ‘shrinking’ or ‘stretching’ in real time,” explained Stanton. “So visually, they see the hand changing, but then we also provide tactile input, that is, a ‘push’ or a ‘pull’ to their finger that matches the visual changes. So it actually ‘feels’ like the finger is physically altered – it is a very weird sensation.”

– See more on this article here

Ride for Pain and PainAdelaide Report

June 2013, Audrey Wang

Audrey Wang reports on Ride for Pain and the inaugural PainAdelaide Conference 2013.  Click here to read  the full article in the Australian Pain Society Newsletter.

Illusions could be key to pain management

29 November, 2012 Tasha Stanton

Pain relief for thousands of Australians could one day be attained through nothing more than some video trickery.

Speaking at a medical research conference on the Gold Coast, Adelaide-based Tasha Stanton has told delegates about her work on how illusions can be used to relieve chronic pain.  Using a device known as Mirage, doctors can manipulate real-time video images of a patient’s pain-affected area and, in combination with other sensory tools, trick the brain.  The device’s near-miraculous properties were discovered by accident when the University of Nottingham in England allowed people to try out the illusion during an open day in 2010. Several of those with arthritis who used the device reported a significant reduction in pain, suggesting a more practical application for the technology than originally intended.

More here – reported by ninemsn, 7News, and NT news

Acupuncture research – the path least scientific?

31 October 2012 Neil O’Connell and Lorimer Moseley

A recent, rather flattering, article on acupuncture on this website holds a mirror to a broader problem in the world of acupuncture research. A problem that goes to the heart of the most fundamental scientific principles.

There’s no doubt that acupuncture is gaining traction on the grounds that it holds up under scientific interrogation. But does it really?

Let’s go back to basics. The scientific method involves proposing a theory based on plausible principles, and then trying to disprove it. Let’s say the theory proposes that a particular treatment is effective for a certain condition.

First, we ask whether it’s based on plausible principles. And, if so, we design studies to rule out every possible explanation for the observed effect except the explanation captured in the theory. If the effect remains after all reasonable controls have failed to remove it, we conclude that, on balance, it’s probably real.

To read the full article go to the original article in the Conversation.

Make it Stop – September Issue of Men’s Health Magazine.

September 2012

Lorimer Moseley and James McAuley feature in the September issue of Men’s Health in an article on chronic pain and its management (click on the cover image below to read the article or download the PDF).

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Mixed Signals – LiveMind, The Wall Street Journal

9 August 2012 Lorimer Moseley

Pain is a protective experience: It’s our brain’s siren call to get us to pay attention to what it perceives as a dangerous situation for the body. If you accidentally sprain your ankle while running, the brain tells you that it hurts so that you tend to your ankle immediately. If you didn’t feel the pain after spraining your ankle, you’d keep running and seriously damage your ankle. “Pain is one of life’s most sophisticated mechanisms, assisting us to successfully navigate our physical environments,” says Lorimer Moseley, professor of clinical neurosciences and chair in physiotherapy, School of Health Sciences, University of South Australia, in an email interview. Sometimes, though, pain can become the illness itself…..

[We'd like to correct one of the paragraphs in the original article:]

…“For example,” says Dr Moseley, “we have experts in pain biology that teach patients about how pain really works. We nearly always have to introduce people to a new way of thinking and we have learnt that the best way to do this is via stories and metaphors. We often need a good psychologist who can help the patient to think differently, to learn skills that make the pain more manageable, to develop other skills that make the long journey to recovery more likely. Then SOMETIMES we need a very astute and informed musculoskeletal physician who can USE RIGOROUS METHODS TO DETECT WHETHER a structure or a nerve IS CONTRIBUTING TO THE SITUATION.

Go here for the complete Mixed Signals article.

Pain really is in the mind, but not in the way you think – The Conversation

7 August 2012 Lorimer Moseley

Everybody hurts, but not everybody keeps hurting. The unlucky few who do end up on a downward spiral of economic, social and physical disadvantage.

While we don’t know why some people don’t recover from an acute episode of pain, we do know that it’s not because their injury was worse in the first place. We also know that it’s not because they have a personality problem. Finally, we do know that, on the whole, treatments for chronic pain are not particularly successful.

This sobering reality draws up some interesting reflections on pain itself. What is pain? Is it simply a symptom of tissue damage or is it something more complex? One way to approach this second question is to determine whether it’s possible to have one without the other – tissue damage without pain or pain without tissue damage.

And you can answer that one yourself – ever noticed a bruise that you have absolutely no recollection of getting? If you answered yes, then you have sustained tissue damage without pain. Ever taken a shower at the end of a long day in the sun and found the normally pleasantly warm water, painfully hot? That’s not the shower injuring you – it’s just activating sensitised receptors in your skin.

Such questions and their answers are of great interest to pain scientists because they remind us that pain is not simply a measure of tissue damage.

For more on this article see Pain really is in the mind, but not in the way you think at the Conversation.

Chronic pain distorts sufferers’ sense of space and time – UniSA news

23rd July 2012 Lorimer Moseley

Einstein’s famous theory of relativity proposed that matter can distort space and time. Now a new study recently published in the journal Neurology suggests that chronic pain can have the same effect.

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Neuroscientists from the University of South Australia, Neuroscience Research Australia and the University of Milano Bicocca in Italy, studied people with chronic back pain, the most common painful condition which costs western countries billions of dollars in lost productivity every year.

They presented identical vibration stimuli to the painful area and a non-painful area and noted that the stimuli were processed more slowly by the brain if they came from the painful area.

The most striking finding, however, was that the same effect occurred if the stimuli were delivered to a healthy body part being held near the painful area.

Lead author of the study, Professor Lorimer Moseley from the University of South Australia, says it was not altogether surprising that, in people with chronic pain, there are changes in the way the brain processes information from and about the painful body part.

“But what is remarkable is that the problem affects the space around the body as well as the body itself,” Prof Moseley says….

Read the full article at UniSA news releases

Blog Rankings – a different way of measuring impact

2nd April 2012 Lorimer Moseley

Publish or perish’ is the unofficial motto of scientific life. Get your research out there! Get citations! Get your rankings up! But it’s easier in some areas than others, as University of South Australia pain specialist Professor Lorimer Moseley has found.

Moseley, a professor of clinical neurosciences and the university’s first chair in physiotherapy, has spent the last few years undertaking something of an experiment: together with a team of researchers, he runs BodyinMind.org, a blog and website dedicated to getting the latest research in pain management to the people actually using it in the field, not just the people reading journal articles. More here at Campus review

The champion cyclist – The Australian

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For as long as Amanda Spratt had been riding with the Australian Institute of Sport, she’d had this gnawing demon as a passenger. Picture: Randy Larcombe Source: The Australian

24 March 2012:  …a whole new generation of scientists, doctors and therapists are taking the new understanding of neuroplasticity and asking whether it is the beginning of a revolution that can cure patients such as Amanda Spratt, when all else has failed. After all, they ask, if the brain can change itself, surely it must be possible to convince it to change back? For the full article click here:  The champion cyclist – The Australian

Mind can control allergic response

18th Jan 2012

You – or more accurately, your brain – has control over how allergic your skin is, suggests new research. A team of neuroscientists have found that if someone has a lesser sense of ownership over a part of their body, their immune system also responds differently to that body part, treating it as ‘non-self’ rather than ‘self’. For more see the paper published in Current Biology.  or see the full report  originally published at Neuroscience Research Australia.

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Ideal sitting posture questioned

26 Aug 2009

Dr Andrew ‘Happy’ Claus, led this study on how we sit, how we should sit and it ain’t necessarily so (Andrew would appreciate that….) – ABC Science picked it up – ‘Ideal Sitting Posture Questioned‘ which also got a write up in MedIndia. Although he is currently turning down most requests for public appearances, Andrew has squeezed this in just for BodyinMind.org!

Learning to move phantom limbs

October 2009

Getting a fair bit of interest is Interdependence of movement and anatomy persists when amputees learn a physiologically impossible movement of their phantom limb (PNAS October 26, 2009, online edition) or, as reported in Science Blogs (great write up): Phantom limbs can contort into impossible configurations; New Scientist: Lost limb leads to flexible new body image; Nature: Neurology Impossible Movements; Reuters Health News: Amputees defy anatomy, learn to move phantom limbs, ABC Science: Phantom limbs make impossible moves and ScienceNews: Redefining self, phantom self.

Inspirations:

Here is an email received by the superb Anna-Louise Bouvier. She was kind enough to send it on (with the sender’s permission!)

“Hi, I saw you on the Today Show today and thought you might be interested in my son’s condition. My son Mike, 19yrs, went on a ski trip and had a fall, didn’t break anything but injured his left back/shoulder. He spent 3 years at home in pain. He collapsed 4 times, saw every specialist on the Gold Coast. Had mri’s, ct scans, all revealed nothing. They thought it was nerve damage, he had day surgery trying to freeze the nerves which didn’t work and sent his back into spasms and more pain.

Eventually they sent him to the Chronic Pain Unit at the Gold Coast Hospital. They spent 5 weeks with him, about 5 hours a week. They realised any tests he did with the right side of his body he got 100%, left side was 40%.

They used mirror therapy to trick his brain – got him to remove his ring from right hand to left and do exercises in the mirror – gave his mind exercises. Said they thought his body had a little bit of pain but his mind was saying ‘oh my goodness this pain is unbearable’ and after 5 weeks of treatment from the psychologist and occupational therapist he said – Mum, it doesn’t hurt anymore!

He has been pain free for a year now. I couldn’t believe after 3 years of all the tests and treatment he went through that it was all to do with the mind. I hope you can keep going with your research so that no other kid has to go through this and it is diagnosed sooner.”

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