Cartographers need not apply: Skin-based maps are self-organising

Many of us will have heard of the visual blind spot, scotomas (an area of partial or complete loss of visual acuity in an otherwise clear field of vision) and phantom limb sensations, but what do these have in common? They show us that despite a void in our perceptual field, we can maintain a somewhat stable perception. Compensation for the missing … [Read more...]

Beyond Balance: outpatient opioid taper without pain increase is possible

Opioid policy debates are often framed in terms of balancing opioid risks with chronic pain relief. This assumes, not only that opioids provide long-term pain relief, but that opioids are necessary for pain relief. Based on our many years’ experience with successful opioid dose reduction in our structured multidisciplinary pain rehabilitation … [Read more...]

Can fear of movement lead to physical inactivity in low back pain?

It’s well known for most health professionals who regularly treat patients with back pain that often patients are afraid of moving because they believe that movement will cause further pain and injury. This fear of movement, and belief that physical activities will cause (re)injury, is the central concept of the well-known Fear-Avoidance Model. … [Read more...]

Pain, Disparities, and the Perils of the Endless Loop

“I can’t stop thinking about how much it hurts!” “I’m scared the pain will get worse!” “There’s nothing I can do to make it better!” These and related expressions may ring familiar to pain sufferers – their friends, family, and clinicians too. They are 3 of the many examples of catastrophic reactions that often occur around pain. More … [Read more...]

Tactile acuity in acute pain: do we not see the wood for the trees?

It is well known that chronic pain is associated with changes in the brain: Several lines of research confirm alterations in the central nervous system in chronic pain syndromes including phantom limb pain, complex regional pain syndrome, patients with fibromyalgia, osteoarthritis and - the most prevalent syndrome - chronic non-specific low back … [Read more...]

A new method of assessing women with pelvic pain

Are you female? Do you know any females? Chances are, the majority of you are thinking ‘yes’. And chances are, the majority of those females you know have experienced pelvic pain. Almost every woman will experience pain during menstruation (dysmenorrhoea) at some point during her life[1] – and usually it seems like some kind of uterus-driven … [Read more...]

Online Breast Cancer Laterality Study

  It is estimated that one in eight women will develop breast cancer over their lifetime (American Cancer Society, 2015). Terrific advances in modern screening and treatment approaches mean that many women will survive – there are nearly three million breast cancer survivors in the U.S. alone. However breast cancer treatments can cause … [Read more...]

“I need to do another course” – Physiotherapists’ views on assessing psychosocial factors in chronic low back pain

Psychosocial factors (PS) are described as the combination of an individual’s cognitive, emotional and social status that can influence their health status (Singla et al., 2015) and they include: patients’ beliefs that pain and activity are harmful, fear avoidance beliefs, negative behaviours, lack of support, overprotective families, physical … [Read more...]

Pregabalin for sciatica, increasing prescription but is it effective?

Few clinical guidelines for the treatment of sciatica exist and evidence regarding effective medical treatments is limited. One medicine that is prescribed for the management of sciatica is pregabalin (also known as Lyrica®). Pregabalin is a neuropathic pain medicine, effective in reducing neuropathic pain in conditions such as post-herpetic … [Read more...]

Restoring movement representation with virtual reality alleviates phantom limb pain

Working hypothesis about phantom limb pain and movement representation Patients with phantom limb pain (PLP) may report altered movement representations of their phantom limb, for example, ‘my phantom limb is frozen in one or more peculiar positions’. Dr. Sumitani previously reported that visual feedback using a mirror restored the voluntary … [Read more...]