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...]

It is not just the brain that changes itself – time to embrace bioplasticity?

My mate Dr Mick Thacker, has long been teasing me for being neurocentric. In fact - for being A neurocentric. That is, he attaches this neurocentricity to me not just as a characteristic, but as an identity. Moving on from positions of prejudice first requires understanding and I have slowly come to understand that pain is not an emergent property … [Read more...]

Motor dysfunction in Complex Regional Pain Syndrome is related to proprioceptive deficits

Imagine that you want to grab a cup of coffee. Successful planning and execution of this and many other everyday life tasks crucially depends on a good sense of the position and movements of your body parts (= proprioception). Such tasks would be very difficult to perform if you have no (or perhaps the wrong) idea of where your hand is, or what it … [Read more...]

Preoperative Neuroscience Education for Lumbar Radiculopathy

Adriaan Louw

Another in our 'getting your thesis out there' series.  This one from Adriaan Louw, PT, PhD. Congrats Adriaan on finishing your thesis! Background: On average one in three patients following lumbar surgery (LS) for radiculopathy experience persistent pain and disability following surgery. No perioperative treatments have shown any ability to … [Read more...]

Should we train deep trunk muscles to improve the clinical outcomes of low back pain?

Transversus abdominis (TrA) and lumbar multifidus (LM) are two deep trunk muscles implicated in maintaining spinal stability at rest and during physiological movements. A number of research studies have found that people with acute, chronic or recurrent low back pain (LBP) show abnormal changes in the physical characteristics (e.g. shape, … [Read more...]

The fascia and back pain – What does a chemical stimulation tell us about it?

Andreas Schilder

Back pain is a worldwide problem causing time lost from work, disability and economic cost. Over 75% of humans suffer from back pain at least once in their lifetime and the yearly prevalence of the working population is 8%, where the lower back represents the most mentioned region. Disorders of osseous structures, disc herniations or nerve root … [Read more...]

Acupuncture and awareness

We have just published the results of a small experiment looking at acupuncture in people with chronic low back pain (see here). Now that is not a sentence I thought I would ever write, so there is some explaining to do. Acupuncture is a common treatment for back pain and one that has been well researched. The outcome of this research effort is … [Read more...]

Low back pain: does shoe type make a difference?

Sian MacRae

Low back pain effects up to 80% of the population at some point in their life time. Although national and international guidelines recommend exercise therapy as a best practice in the management of chronic low back pain (pain that has been present for 3 months or greater) the long term benefits of exercises to people with low back pain are minimal. … [Read more...]

Stability of conditioned pain modulation in patients with chronic pain: Implications for pain assessment & treatment

Marc O Martel

Over the past few decades, considerable evidence has accumulated indicating that pain may be modulated by a variety of endogenous pain-inhibitory processes. These operate at various levels of the central nervous system (CNS), and play a role in shaping the subjective experience of pain. Importantly, several lines of research suggest that … [Read more...]

Chronic Pain: Lost Inhibition?

While working with chronic neuropathic pain sufferers over the last few years, quite often I was asked if there is a “pain center” within our body, particularly in the brain, where pain is generated. One of my chronic pain patients actually quipped: “If you tell me where the pain hub is I will go to a surgeon and let them cut it out”. … [Read more...]