Group Cognitive Behavioural Therapy – can we do better?

Cognitive behavioural therapy (CBT), a  management strategy for chronic pain and its consequences [1], is frequently conducted in groups to minimise cost [2] and maximise efficiency. Although clinicians often report knowing when a group will go well or badly based on who is in the group, evidence that group composition can influence outcomes is … [Read more...]

Why physical therapy treatments for low back pain may not be living up to their potential

Low back pain (LBP) is a leading contributor to people living with disability throughout the world,1 and the problem appears to be getting worse rather than better.2 Scientists and clinicians, therefore, need to improve treatment for LBP to shift this trend and reduce disability. People with LBP change how they control their posture for … [Read more...]

Low Back Pain Treatment in Primary Care

In general, most acute low back pain (LBP) recovers spontaneously within a few days or weeks. No active treatment has shown to actually shorten the time it takes for acute back pain to recover. The purpose of medication, manipulation, acupuncture, physiotherapy etc. is at best to ease the pain while one is waiting for nature to heal. And one should … [Read more...]

Placebo responses and central neuropathic pain: from meta- to pooled analysis of clinical trial data

Defined as a reduction in pain without a biologically active therapeutic, the placebo response includes the placebo effect (i.e., psychobiological factors that cause a reduction in rating) in addition to other contributing factors, such as natural and expected fluctuations in pain [4]. To improve the design of future clinical trials, recent work … [Read more...]

Cognitive Functional Therapy for chronic low back pain: The patients’ perspective

Pain and lack of function are the two main factors that motivate people with non-specific chronic low back pain (CLBP) to seek care [1]. When you ask a person with CLBP what treatments they have tried, the answer is often in the form of a shopping list: manual therapy, stabilising exercises, Pilates, yoga, medication, injections… and so might the … [Read more...]

The Strange Case of Interoception and Resilience or How to Become a Superhero

Steel is a very resilient material: it has the capacity to absorb the energy produced by a hit without breaking. Translating this original definition of resilience into the Psychology field, a person is resilient when they can cope well with stressful situations. No wonder Superman is called “man of steel”! Back to more scienc-y stuff, recently … [Read more...]

How well can clinicians predict the future?

“When will this be over?” “Will my back ever be good again?” When consulting for back pain the first thing on many patients’ minds is “How long will this last?” or “Will my back ever be as good as before?” In other words, they would like to know their prognosis [1]. However, it is actually not easy for clinicians to predict individual … [Read more...]

Put your money where your mouth is – introducing EPIC by Entropy

Many of you will know that at BiM, we have a policy of not promoting particular treatments or clinicians. This is because that is not in our remit. One thing that is well and truly in our remit however, is the advancement of better, and more science and evidence-based treatments by everyone. There are many ways we try to promote this advancement - … [Read more...]

Could telling right from left be a way forward in low back pain

Lately more and more research has indicated changes in cortical processing and disruptions of bodily representations in patients with low back pain (LBP). Among these findings, which have also been noted with other painful conditions, is impaired performance in laterality judgments [1,2]. While the exact relationship between LBP and laterality … [Read more...]

What’s best for chronic spinal back pain? Physical, behavioural/psychologically or combined interventions?

Non-specific chronic spinal pain (NSCSP), particularly low back pain (LBP) and neck pain (NP), results in significant personal, social and economic burden(here and here).[1,2] Our research group has recently published a systematic review and meta-analysis[3] in the Journal of Pain comparing the effectiveness of conservative interventions for … [Read more...]