N=1 as a reference for general concepts of experiencing pain

This post is the second in a series of posts on BiM about chapters in the edited collection, Meanings of Pain (2016, Springer). -- Should we allow our own experiences to guide our research? While ‘objectivity’ is being strived for in quantitative research, Rysewyk and Baeyer (2016) argue that researchers should focus more on their own … [Read more...]

A call to study the Meanings of Pain

This post is the first in a series of posts on BiM about chapters in the edited collection, Meanings of Pain (2016, Springer). We kick off the series with a question and answer session between Simon van Rysewyk, editor and contributor of Meanings of Pain, and Lorimer Moseley (LM), Editor-in-Chief of BiM. LM: Why make a call to study the Meanings … [Read more...]

Exercise considerations for chronic musculoskeletal pain

Chronic musculoskeletal pain (CMP) encompasses a diverse range of conditions such as osteoarthritis, discogenic spinal pain, fibromyalgia and chronic widespread pain. There is consistent evidence for the benefit of exercise to improve pain and function in CMP, although there is considerable uncertainty concerning the best exercise modality and … [Read more...]

Assessment of movement control impairments of the neck

In a study on patients with and without neck pain we set out to evaluate a battery of ten movement control tests for the neck using a Rasch analysis (Sattelmayer, Hilfiker, Luomajoki, & Elsig, 2017). The aim was to establish whether all movement control tests measure the construct “movement control impairments of the neck”, to establish the … [Read more...]

Embodied Pain: negotiating action

We determine our world through the actions we take. Whether from the inside or out, our bodies provide us with the means to actively investigate our environment. This investigation is vital to survival. Active investigation enables us to reduce the uncertainty of the world, accommodate the unexpected, and better predict the consequences of our … [Read more...]

Frozen shoulder: fact or fiction?

The term ‘frozen shoulder’ captures the imagination, and carries the implicit suggestion that if frozen it can then thaw. Our paper “Natural history of frozen shoulder: fact or fiction?” published this year in the journal Physiotherapy [1], is a systematic review of the literature regarding the conventional story that a frozen shoulder progresses … [Read more...]

Managing low back pain in secondary care:  Should we screen to target those ‘at risk’ or treat them all?

This study [1] arose out of a clinical aspiration to do things better.  Daily practice in secondary care spinal clinics at a large metropolitan hospital saw distressed and disabled patients with low back pain (LBP) come and go.  Many had waited months or years for ‘surgical’ consultation, only to be promptly discharged – with “community-based … [Read more...]

Clinical prediction rules: Use the babies and throw the bathwater?

There are easily a thousand clinical prediction rules (CPRs) related to managing musculoskeletal pain. Okay, maybe a thousand is an exaggeration. My point is there are many. All designed with the aim of helping clinicians to make more certain decisions about diagnosis (diagnostic CPRs), prognosis (prognostic CPRs) or likely response to an … [Read more...]

Reductionism vs The Big Picture – can we have our kayak and heat it too?

I am down on sleep and have penned a rather personal post, because right now, on the back of some outstanding conversations with some truly impressive newly ‘graduating’ Anaesthetic and Pain Medicine fellows*, it seems an important reflection to share. Yesterday I caught up with my good mate Jono.  Conversation with Jono is always rewarding. He … [Read more...]

Cartographers need not apply: Skin-based maps are self-organising

Many of us will have heard of the visual blind spot, scotomas (an area of partial or complete loss of visual acuity in an otherwise clear field of vision) and phantom limb sensations, but what do these have in common? They show us that despite a void in our perceptual field, we can maintain a somewhat stable perception. Compensation for the missing … [Read more...]