The dynamic effect of pain on attention

Pain tends to grab our attention, making it difficult to concentrate on other tasks. This is generally a useful feature of pain – if we burn ourselves while cooking, it’s good that our attention switches away from the food and towards the pain so that we can adequately protect ourselves. However, if the pain doesn’t signal threat (e.g. a tension … [Read more...]

Do depressed people experience more physical pain – or less?

Recent global burden of disease surveys tell us that pain and depression are two of the most common and pervasive issues in modern society. The fact that these two are also highly comorbid hardly generates surprise. Living with chronic pain often means restricted mobility, reduced capacity to work and general impairment of quality of life, in … [Read more...]

Quantitative Sensory Testing in Chronic Musculoskeletal Pain

Introduction Our recent review, published in “Pain Medicine”, highlighted the measurement properties of quantitative sensory testing (QST) and its clinical utility. QST results have been shown to be related to pain or neural sensitivity. QST has been put forward as a potentially useful tool for monitoring disease prognosis and evaluating … [Read more...]

Low-grade inflammation and the brain

What is inflammation? We usually talk about “inflammation” in relation to infections and injuries. When the body is infected, the immune cells recognize the ‘non-self’ molecules and produce inflammatory factors, called “cytokines”, to coordinate the fight against the infection. Cytokines signal other immune cells and bring them to the site of … [Read more...]

Optimizing the impact of research in chronic pain

Evidenced-based medicine integrates clinical experience with the results of the best available clinical research data to inform treatment decisions. Optimal application of evidenced-based medicine requires 2 things. First, the results of clinical research must be reported in the peer-reviewed literature in a clear, concise, and transparent manner … [Read more...]

“Encontros Saúde & Dor” Bringing Pain Education to Low-Income Communities in Brazil

Approximately 11.25 million Brazilians live in low-income communities or “favelas.” In my home town of Jundiaí, near São Paulo, there are no less than 14 of these low-income communities, the largest of which houses approximately 15 000 families. Some low-income communities, such as Rocinha in Rio de Janeiro, are home to up to 180 000 people. At … [Read more...]

The false promises of shared decision making in rehabilitation

In the recent years, Shared Decision Making (SDM) has been increasingly advocated as an ideal model of treatment decision-making during the medical encounter, as it has been shown to increase benefits for both clinicians and the health-care system (1).  But does SDM result in better outcomes for patients with painful musculoskeletal conditions?  In … [Read more...]

What pain-related factors are associated with lost work days in nurses?

Low back pain (LBP) is a leading cause of disability [5] including lost work days (LWDs) and early retirement [3; 4]. Among the work-related disability domains, LWDs are particularly important because they increase the economic burden of pain for the individual, family and society.  A number of factors such as overall work demands, working on a … [Read more...]

Could Virtual Reality Dodgeball motivate fear-avoidant CLBP patients to move? Implications for future treatment.

Chronic low back pain (CLBP) is one of the most common musculoskeletal conditions health care professionals encounter. Unfortunately, despite ever increasing costs in regards to clinical management, the results remain underwhelming[1,2] giving CLBP an enigmatic nature. As a masters student I am interested in understanding how the neuromodulatory … [Read more...]

One-to-one or strength in numbers – is there a best way to deliver exercise based physiotherapy?

Musculoskeletal (MSK) conditions are common and costly, resulting in significant personal, social and economic burden (here and here) [1, 2]. While physiotherapists deliver many interventions (e.g. massage, spinal manipulation, dry needling, etc.), exercise is probably the most commonly used and researched component of physiotherapy, with many RCTs … [Read more...]