Doses and processes in pain management

Amanda Williams

In considering whether we can answer the question of whether there is a dose-response relationship in psychologically-based pain management for chronic pain problems, we need to step back a bit and think about what dose-response means. It’s based on a very simple notion of medication, perhaps of analgesia: that a small dose produces a small effect, … [Read more...]

Do brain changes really contribute to persistent low back pain?

If you’ve recently attended a pain conference, had a glass of wine with a pain boffin or spent time googling ‘pain’ you’ve no doubt come across the terms ‘neuroplasticity’ and ‘central sensitization’. These buzzwords are increasingly used to describe biological changes that might contribute to persistent low back pain. But do they really explain … [Read more...]

Medical exercise therapy breaks the chronic pain cycle, even in the longer term, in patients with persistent anterior knee pain

Fig 2

In general there is a lack of long-term success in treating people with persistent musculoskeletal pain and long-term anterior knee pain or patellofemoral pain syndrome (PFPS), is no exception [1].  It is reported that approximately 25% of patients with PFPS continue to have pain and dysfunction one year or more after physiotherapy, the most … [Read more...]

Affective Touch by Others Determines how we Perceive our Own Body

Katerina Fotopoulou

Just why does the touch of a loved one feel so good? The answer may have something to do with the fact that slow, gentle touches from another person (like the caress of a loved one) can enhance our sense of self – specifically, the feeling that our body is our own (i.e. the sense of body ownership). This sense of body ownership seems indubitable; … [Read more...]

Dying values? Does pain matter?

Many established values of palliative care practice (like symptom relief, truth-telling, alleviation of suffering) are based on research done outside of Africa, yet African patients may have different values when it comes to death and dying.  A group of South African researchers sought to find out what processes Xhosa people (a 7.9 million-strong … [Read more...]

We all know that falling over hurts, but can pain come before a fall?

Brendon Stubbs

We have all fallen over, haven’t we? Well you know that it hurts, and you can imagine this is also the case for those of an older age with an increased risk for falls. But how about vice versa? Is pain itself a risk factor for falls in this older group?  This is important as preventing falls is a serious public health issue since fall related … [Read more...]

Could pain science be becoming fashionable? WCPT announces successful symposia.

The World Congress on Physical Therapy, which will be held in Singapore next May, has just announced the successful proposals for symposia. There were, apparently, a very large number of submissions. However, an intriguing thing has happened - 20% of symposiums are focussed on pain. At first glance, one might think - only 20%? However, if that is … [Read more...]

Overhauling the design of psychological treatments for pain: Time for a radical change?

Morley and colleagues[1] recently conducted a topical review that focuses on meta-analyses for evaluating psychological treatments for chronic pain. I enjoyed reading this opinionated and somewhat strongly worded call to, in short – do better. Published in one of the premier journals in the field, PAIN, the authors are quite bold in their … [Read more...]

Subgrouping patients with chronic whiplash on the basis of symptoms of sensory hypersensitivity and PTSD

Ash Pedler

A significant proportion of people (up to 50%) who develop neck pain following a car accident continue to report neck pain at long term follow up. It's not clear why these patients don't recover and unfortunately current evidence seems to indicate that usual rehabilitative management is not very effective for patients with chronic whiplash. The … [Read more...]

Spinal manipulative therapy: a slow death by data?

Neil O'Connell 2

I am a recovering manual therapist. In my physio career I have moved from freshly qualified apprentice, eager to learn the secrets of what was sold as a powerful tool, particularly for spinal pain, via what might be classed as a skilled practitioner, certainly in terms of courses attended and assessment hoops jumped through, to someone who now … [Read more...]