Painful view on motor actions

Imagine you sprained your wrist. It’s aching, swollen and reddish. You want to move the hand to see if it is ok, but the fear of pain makes you hesitate and it takes extra effort to do it. Even thinking about movement can be unpleasant and you focus on doing things with the healthy hand. After days and weeks, as the trauma heals, the pain passes … [Read more...]

tDCS – the bigger picture

Last year I told you about a trial where we compared the brain’s activity during pain processing in the fMRI scanner before or after the application of an electrical brain stimulation technique (transcranial direct current stimulation (tDCS)). The result was that there wasn’t much change after tDCS, hence we raised doubts that tDCS had an effect on … [Read more...]

EP 15 years in: historical and theoretical underpinnings

This is my second post based on a perspectives piece David Butler and I wrote for the Journal of Pain. You can get the gist of it by just reading the bolded sentences. It is some time now since John Loeser adapted Engel’s biopsychosocial model to fit it to the lived experience of chronic pain. From my perspective as someone who had experience on … [Read more...]

Isometrics reduce tendon pain

Anyone with tendon pain will tell you, it’s a pain in the butt (hamstring tendon pain that is). If it’s your Achilles tendon, the mornings are a struggle and you may have stopped walking, running or playing with your kids. For the athlete, pain relating to the Achilles, Patellar, Hamstring or Adductor tendons can strip away power and spring needed … [Read more...]

Brain Image Biomarkers for Pain: Why should we?

Indulge me for a moment. Let’s say you just arrived at your physician’s office with a troubling symptom. She says “Hold on, I need to put you in the MRI to see if this symptom is pain, or if you are a pain patient.” There have been a number of scientific papers and popular press releases that suggest we need to replace self-report of pain … [Read more...]

15 years of Explaining Pain – where have we been and where are we going?

Neuroscience was clearly my favourite course at uni – I loved it so much I was learning for fun, not for exams. I don’t recall ever studying for a neuroscience exam – it all seemed to magically stick in there – as if there were tailored docking stations in my brain just waiting for their particular neuroscience nugget to lock in. I found it … [Read more...]

How does sensory and sympathetic nerve sprouting contribute to a chronic pain state in a nonhealed fracture?

Our lab continues to be intrigued by the mechanisms that generate and drive skeletal pain. Painful skeletal conditions are highly prevalent and their impact is pervasive in both developing and developed countries (Lubeck, 2003;Woolf & Pfleger, 2003; Brooks, 2006; Kidd, 2006). The skeletal system is essential for structural support, movement, … [Read more...]

Leprosy and Pain: an Old Disease with a New Challenge

Perhaps you have already heard about leprosy in the past. Despite major efforts to eradicate leprosy, this infection still affects 250,000 new individuals per year [1]. The mode of transmission of leprosy is probably person to person through nasal secretions from untreated patients. The disease is well known because of the biblical stories and it … [Read more...]

Core outcome domains for non-specific low back pain

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

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...]