World Congress on Pain comes to you. 4: Learning Pain pt 2

Have a quick skim of the last blog post: this one follows on, as Part 2 of our synopsis of Professor Johan Vlaeyen’s plenary lecture at the World Congress on Pain... Having explained non-associative learning and Pavlovian conditioning, Prof Vlaeyen moved on to operant conditioning, a behavioural model of learning which Skinner proposed and … [Read more...]

World Congress on Pain comes to you. 3: Learning Pain pt 1

Professor Johan Vlaeyen delivered his plenary lecture at the World Congress on Pain over video. The IASP promised to provide the recording on their website, but some of you had already asked for blog posts on the congress sessions, so I will provide a synopsis of Prof Vlaeyen’s lecture here. His talk was a helpful exploration of the roles that … [Read more...]

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...]

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...]

Illusory Perceptions

Postman Pat

A person, let’s say his name is Pat, views a staircase in front of him; he is delivering a parcel (Postman Pat) and must climb three flights of stairs to deliver it to flat 15. Pat has knee pain and stairs aggravate his pain. Just as Pat is surveying the stairs, a (pain-free) resident sidles passed him and makes his way up; Pat follows behind him. … [Read more...]

Generating Much Interest (aka GMI)

Graded motor imagery (GMI) for the treatment of chronic pain has certainly been generating much interest recently. Earlier this year, I was lucky enough to publish a systematic review and meta-analysis - with a pretty snazzy bunch of researchers might I add - looking at the effects of GMI and its components on chronic pain. We published our article … [Read more...]

Potluck? Might Cannabis reduce neuropathic pain?

The Journal of Pain’s 4th most downloaded article in 2013 (Wilsey ey al 2013) is a study of vaporised cannabis for the treatment of neuropathic pain.[1]  Thirty-nine patients, with various types of refractory neuropathic pain, participated in a double-blind crossover study, receiving low-dose (1.29%), medium dose (3.53%) or placebo cannabis in each … [Read more...]

The Fear-Avoidance Model moves forward

Petra Karsdorp, Stéphanie Volders, Ann Meulders, Judy Veldhuijzen

New research from the '7th World Congress on Behavioural and Cognitive Therapies’ Cognitive and behavioural therapy (CBT) is the most widely researched and used approach in psychology. A recent review of 108 meta-analyses showed that, when compared to other treatments (for psychological problems), CBT generally proves to be equally or more … [Read more...]

Does pain affect slow wave sleep – inference

happy rat

A brief review of the paper: Disturbances in slow-wave sleep (SWS) are induced by models of bilateral inflammation, neuropathic, and postoperative pain, but not osteoarthritic pain in rats. [1] Part 3 of 3: how would humans be affected by reduced slow wave sleep? Though the mechanisms between noxious stimuli and SWS are yet to be fully … [Read more...]

Does pain affect slow wave sleep – critique

A brief review of the paper: Disturbances in slow-wave sleep (SWS) are induced by models of bilateral inflammation, neuropathic, and postoperative pain, but not osteoarthritic pain in rats. [1] Part 2 of 3: critique of the study Closer examination of the data provided shows that the greater the reduction in percentage of SWS2 (deeper SWS) … [Read more...]