But they walked, hopped and jumped on it!

From the days of my infancy as a physiotherapist, I was raised on the teaching that pain should be measured by subjective means only. You have to ask the patient. You cannot presume to judge the magnitude of their experience: you ask them, and they tell you. If they say it’s a 2 out of 10, that’s what it is. If they say it’s an 11 out of 10 (I see … [Read more...]

tDCS – negotiating the “rising tide” of hype.

By now most of you will have heard of transcranial direct current stimulation (tDCS). It’s been all over the media in recent years and original research has been flooding through the neuroscience and clinical journals. In a nutshell it involves the non-invasive delivery of low intensity direct current applied to the brain via electrodes that are … [Read more...]

What is the relationship between physical activity and low back pain?

The Australian Twin low BACK pain (AUTBACK) study Almost all guidelines for the prevention and management of low back pain (LBP) emphasise the importance of regular physical activity and exercise [1, 2]. Surprisingly, the question of whether physical inactivity in general, or specific forms of physical activity, are risk or protective factors for … [Read more...]

Exercise for chronic whiplash – the road to Nullville.

It seems like only yesterday I was blogging about an important trial of targeted care for acute whiplash, which like other such trials returned a convincingly negative result. It seems that our best efforts at improving outcomes in the early stages after whiplash injury do not achieve their goals. But what about when we intervene with a group of … [Read more...]

PainAdelaide 2014 – Wrapping-up and looking forward

Wrap-upThanks so much for being a part of possibly (probably!) the best little pain meeting in the world - PainAdelaide 2014.  We thought it was a roaring success and a large part of that is because of the feel in the room, to which you clearly contributed!  Our overseas visitors were very impressed with the meeting. They commented on the … [Read more...]

Emerging research trends on the relationship between sleep and pain

The relationship between pain and sleep quality is well reported in the literature. Sleep complaints are present in up to 88% of chronic pain disorders [1] and at least 50% of patients presenting with insomnia also suffer chronic pain [2]. This short blog post focusses on a recent review by Finan, Goodin and Smith (2013) who aimed to identify … [Read more...]

Dying values? Does pain matter?

Many established values of palliative care practice (like symptom relief, truth-telling, alleviation of suffering) are based on research done outside of Africa, yet African patients may have different values when it comes to death and dying.  A group of South African researchers sought to find out what processes Xhosa people (a 7.9 million-strong … [Read more...]

Could pain science be becoming fashionable? WCPT announces successful symposia.

The World Congress on Physical Therapy, which will be held in Singapore next May, has just announced the successful proposals for symposia. There were, apparently, a very large number of submissions. However, an intriguing thing has happened - 20% of symposiums are focussed on pain. At first glance, one might think - only 20%? However, if that is … [Read more...]

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...]