Giving patients the whole truth

I am guilty of being the eternal optimist in my practice. I can’t recall ever telling a patient that the outlook isn’t great for them, even though on many occasions, I had that sinking feeling in my gut. Many patients in pain are distressed enough – they don’t need me to give them more to worry about, do they? Maybe I’m not the only clinician who … [Read more...]

The Pain Squad App

We know that pain is one of the most common and distressing symptoms for children with cancer. This pain results from many different aspects of cancer and its treatment, including things like chemotherapy, surgeries and repeated needle pokes with blood work and other tests. Pain can negatively impact on many aspects of a child’s life. To best treat … [Read more...]

No brain, no pain: it is in the mind, so test results can make it worse

This post was first published on TheConversation. Here it is in a slightly longer format. NPS Medicinewise has just launched its Choosing Wisely Australia, tagged with the line ‘An important conversation about unnecessary tests, treatments and procedures’. They have gathered an impressive collection of collaborators … [Read more...]

Medical exercise therapy breaks the chronic pain cycle, even in the longer term, in patients with persistent anterior knee pain

In general there is a lack of long-term success in treating people with persistent musculoskeletal pain and long-term anterior knee pain or patellofemoral pain syndrome (PFPS), is no exception [1].  It is reported that approximately 25% of patients with PFPS continue to have pain and dysfunction one year or more after physiotherapy, the most … [Read more...]

Breast pain an issue for 1 in 3 female marathon runners

The breast itself has limited support of its own and as a result moves during activity. This can result in exercise related breast pain, experienced by up to 70% of exercising women [1].  We surveyed 1,285 female marathon runners [2] taking part in the 2012 London Marathon whose bra cup sizes ranged from an AA cup to an H cup, and underband … [Read more...]

Can the internet help? Promising results from an online Pain Course

Every day, around the world, clinicians and scientists are working hard to better understand and treat chronic pain. Important advances are being made every day. However, many people are left to live with chronic pain and to manage its impact on their day-to-day lives. For many people this can also lead to feelings of frustration, stress, anxiety, … [Read more...]

42.9 billion dollars, the real cost of incontinence

It’s something that almost five million Australians live with every day. One person in every four. That’s someone you know, or maybe it’s you. But despite this statistic, there remains a general reluctance by many to discuss the nature and gravity of these problems. While the life-altering issues experienced with continence concerns can be … [Read more...]

Teaching people about pain – why do we keep beating around the bush pt 2

Continued from previous post ... All is not lost, however. There is an emerging body of literature that suggests that we can change the way people understand their pain. We can reconceptualize pain in a way that makes clear the distinction between tissue damage, nociception and pain. The bulk of the work in this area is guided by a model that … [Read more...]

Teaching people about pain – why do we keep beating around the bush

A frank approach to interpersonal communication brings with it some challenges, but having to dig oneself out of a hole, created by strategically avoiding the truth, is not one of them. This frank approach is well suited to science – the scientific process requires us to pursue and report the truth, the whole truth and nothing but the truth. We do … [Read more...]

Classification based cognitive functional therapy for back pain

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 doctor said I had a back of a 70 year old. He said I couldn’t surf again and or … [Read more...]