Macrophages are key players in pain and analgesia

Macrophages are found in all tissues and are critical to injury and repair. Like neurons, macrophages are plastic and acquire different phenotypes based on the external environment. There are two types of macrophages, M1 which secrete inflammatory cytokines, and M2 which secrete anti-inflammatory cytokines. Inflammatory cytokines activate … [Read more...]

Oldies but Goodies – Classification based cognitive functional therapy for back pain

The fifth and last of our 'Oldies but Goodies' series is by Peter O'Sullivan: This story of a 28 year old man with disabling low back pain illustrates the CB-CFT intervention trialled in the RCT in Bergen, Norway. ‘Eight years ago I had a lifting injury at work. It was terrible pain, I was worried so I went to the doctor who ordered a scan. The … [Read more...]

Oldies but Goodies – Everything you wanted to know about CENTRAL SENSITISATION

Over this holiday season we are posting the most read articles from the last five years.  The third is a BiM review of a J Pain paper by Alban Latremoliere and Clifford J. Woolf (AKA L&W) Everything you wanted to know about CENTRAL SENSITISATION By Kerwin Talbot & Lorimer Moseley Another of our series on the Journal of Pain’s most … [Read more...]

Quantitative Sensory Testing in Chronic Musculoskeletal Pain

Introduction Our recent review, published in “Pain Medicine”, highlighted the measurement properties of quantitative sensory testing (QST) and its clinical utility. QST results have been shown to be related to pain or neural sensitivity. QST has been put forward as a potentially useful tool for monitoring disease prognosis and evaluating … [Read more...]

What pain-related factors are associated with lost work days in nurses?

Low back pain (LBP) is a leading cause of disability [5] including lost work days (LWDs) and early retirement [3; 4]. Among the work-related disability domains, LWDs are particularly important because they increase the economic burden of pain for the individual, family and society.  A number of factors such as overall work demands, working on a … [Read more...]

Could Virtual Reality Dodgeball motivate fear-avoidant CLBP patients to move? Implications for future treatment.

Chronic low back pain (CLBP) is one of the most common musculoskeletal conditions health care professionals encounter. Unfortunately, despite ever increasing costs in regards to clinical management, the results remain underwhelming[1,2] giving CLBP an enigmatic nature. As a masters student I am interested in understanding how the neuromodulatory … [Read more...]

One-to-one or strength in numbers – is there a best way to deliver exercise based physiotherapy?

Musculoskeletal (MSK) conditions are common and costly, resulting in significant personal, social and economic burden (here and here) [1, 2]. While physiotherapists deliver many interventions (e.g. massage, spinal manipulation, dry needling, etc.), exercise is probably the most commonly used and researched component of physiotherapy, with many RCTs … [Read more...]

Expressing pain: which patients do we trust?

Trustworthiness is one of those instant judgements we automatically make about other people, affecting our behaviour towards them [1]. We wanted to know whether clinicians’ judgements of patients’ trustworthiness affected their estimation of patients’ pain [2]. There seem to be so many grounds on which the complaint and expression of pain is met … [Read more...]

Neural underpinnings of fear of movement in chronic low back pain – what do we know now?

Manual therapists such as physical therapists or chiropractors observe that some patients with seemingly identical back pain problems recover within weeks while others develop chronic pain and disability. What does research tell us about this phenomenon? Past research has identified and verified that one of the strongest links to the maintenance … [Read more...]

Pain Management – it’s a sham

If we posit that pain is an output of the brain that is based on the perception of threat, it would follow that decreasing threat, whatever it may be, would positively influence a person’s pain experience. This has led to some exciting therapeutic advances aimed at altering threat, which include encouraging patients to rewrite their pain experience … [Read more...]