What is Cognitive Bias?

As Bill Nighy would say, “Cognitive bias is all around us”. Every time you make a decision that involves any element of human judgement, cognitive bias is introduced. While cognitive bias itself is not bad or evil, a failure to acknowledge cognitive bias is a failure to acknowledge the limits of human intuition. Cognitive bias is what makes us … [Read more...]

Who is healthy?

So-called healthy controls are often included in pain studies as controls to compare with patients or as the main study group in human experimental pain studies. However, the definition of what is considered “healthy” varies, depending on the different study centres or the aim of investigation. Furthermore, the assessment and investigation of … [Read more...]

Looking for Achilles tendon pain sufferers!!! (and “Ever wondered why someone would do an Honours degree?”)

Lorimer: I am at the Australian Pain Society meeting in Perth. I have been asked three times in the last day a question like this: ‘What do I have to do to get into a PhD programme?’ Well one way is to do an Honours degree, either as part of a clinical qualification (for example physiotherapy), or as a stand alone post-graduate course. The next … [Read more...]

I can feel your pain so clearly that it makes me trigger my defence mechanisms!

We are very pleased to be hosting Prof Serge Marchand for PainAdelaide 2016. His team recently published an interesting paper and we thought it was a great opportunity for us, and for all those coming to PainAdelaide or subscribing to PainAdelaide at your place (click here to buy a pass), to get a quick window into his work.   The mere … [Read more...]

Reflections on Pain Sensitivity

Pain sensitivity is thought to be a characteristic of each individual that affects the way a painful stimulus is perceived. In simple terms, being pain hyper- or hyposensitive results in the perception of the same stimulus as very painful or slightly painful, respectively. As a matter of fact, the same trauma results in extremely different amounts … [Read more...]

Small fibre neuropathy in Fibromyalgia: cause or consequence?

Dan Clauw recently wrote an insightful editorial for Pain[1], in which he highlighted an important finding about the idea that people with fibromyalgia show signs of ‘small fibre neuropathy’.  Changes in intra-epidermal nerve fibres (‘small fibres’) have been shown in many clinical conditions, including conditions that are characterised by chronic … [Read more...]

When pain is chronic, is a pain score the right basis for opioid treatment?

Our clinical focus on pain scores began in the 1980s when underutilization of opioids to treat pain in patients dying of cancer was first acknowledged and addressed.  For a number of different reasons – sometimes fear of prescribing because of drug regulations, sometimes lack of availability because of restrictions on production, importation and … [Read more...]

Tactile hyperalgesia: new central mechanisms?

Primary nociceptor activity is clearly not the only mechanism that can increase central sensitivity and pain. For example, certain cognitive and emotional states can also enhance pain and act centrally. A recent proposal has suggested that associative learning mechanisms such as classical conditioning, may also contribute to the clinical … [Read more...]

Painful periods

Period pain Period or menstrual pain is also referred to as dysmenorrhoea, and is usually further classified as primary (no evidence of pathology) or secondary (linked to pathology such as endometriosis). Menstrual pain affects about 60% of women who are menstruating [6], although up to 90% of adolescents can be affected [2]. For a proportion … [Read more...]

Can pain be a classically conditioned response?

Well, what do you think? For those who are clinicians, how does your thinking about that question influence your clinical reasoning? Have you ever found yourself saying (or thinking) along lines like this? “Well, he still has pain, and it’s 6 years since his injury. I think that, now, bending forwards is associated with pain for him. We need to … [Read more...]