Sympathetic blocks for complex regional pain syndrome

Based largely on his clinical experience, the founding father of modern pain medicine, John J. Bonica, recommended that complex regional pain syndrome (CRPS) be treated with a series of sympathetic blocks as soon as possible after symptoms develop. Although this sometimes seems to work well, the value of this approach has been questioned because of … [Read more...]

Which treatments are people with osteoarthritis actually using?

Kim Bennell

It has been well established that hip and knee osteoarthritis (OA) is one of the major causes of disease burden worldwide. There is currently no cure and joint replacement is typically reserved for advanced disease, whilst arthroscopy has been shown to have little or no benefit. For over 10 years now there has been substantial evidence supporting … [Read more...]

When I feel your pain

Sophie Vandenbroucke

Imagine you are preparing food with your partner. Suddenly, you observe your better half accidently cutting his or her hand with a kitchen knife. You may feel uncomfortable and distressed. In fact, you might even respond as though your hand has been cut – by experiencing the pain that would be associated with that event. This phenomenon, referred … [Read more...]

The role of significant others in the management of persistent musculoskeletal pain

Serena McCluskey

It has long been acknowledged that persistent musculoskeletal pain can be influenced by environmental factors, with an important source being the interaction between the pain sufferer and their ‘significant other’ (spouse/partner/relative). It is proposed that significant others can reinforce an individual’s unhelpful pain cognitions, such as fear … [Read more...]

World congress comes to you 7: Yes we can (control chronic pain)

In reviewing the notes I took during the workshop “Beyond the ordinary: Innovative psychological and educational approaches to chronic pain treatment” (15th World Congress on Pain, Buenos Aires), one important message stands out: pain is an experience produced by our brain and, for this reason, we can control it. How? During this workshop three … [Read more...]

Classification of low back pain. Are we winning?

Martin Rabey

As clinicians we know that no two people with low back pain (LBP) are identical. However, if we looked at a large number of people with LBP, would we be able to see some patterns emerge? Or similarities that could allow us to group these people together based upon some characteristics of their presentations? The idea of classification systems for … [Read more...]

Sensory conflicts may increase limb pain in CRPS by activating mechanisms of general facilitation of nociception

Lone Knudsen

I continue to be fascinated by the perplexing symptoms of complex regional pain syndrome (CRPS). CRPS is characterised by the changeable nature of symptoms throughout the day and during the course of the disease, and patients with CRPS often perceive the affected limb as larger than its actual size (Moseley, 2005; Peltz et al., 2011). Patients with … [Read more...]

Flexibly Parenting Teens with Pain

Wallace, Dustin - UMKC portrait

Although a teenager with chronic pain might never admit it, research has shown that parents influence their pain and functioning even beyond annoying them (and thus “causing” pain). In fact, research shows that many things parents do, or even think, can impact their child’s pain. Unfortunately, most things are not always good or always bad! Pain … [Read more...]

Phantom limb pain: peripheral or central origin?

Martin Diers

In a recent paper by Vaso et al. (2014) it was suggested that phantom limb pain is driven primarily by activity generated within the ectopic dorsal root ganglia (DRG) (they wrote for BiM on it here). Ectopic activity is abnormal spontaneous activity generated in neuromas in the residual limb as well as in dorsal root ganglions. The authors reported … [Read more...]

Non-specific chronic back pain and hyperalgesia – A different story told by laser stimulation

Thomas Weiss

Despite our best scientific endeavors, what actually causes the pain in chronic low back pain (CLBP) often remains unclear. Approximately 85 % of chronic back pain patients are classified as having non-specific low back pain [1] because a definitive diagnosis cannot be given. That is, pain cannot be confidently attributed to known pathoanatomical, … [Read more...]