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...]

Clean teeth, bad back? Antibiotics for chronic low back pain.

It is unsurprising that there are few-to-no impressively effective treatments for chronic non-specific low back pain. The clue is in the “diagnostic” label. Non-specific low back pain represents the vast majority of cases for whom our traditional diagnoses don’t explain a great deal. If we can’t put our finger on what is causing it, we are likely … [Read more...]

Is GDR effective in the treatment of chronic neck pain?

It was in 2005 that I came up with the idea of a “gaze direction recognition" (GDR) task as a possible treatment for chronic neck pain. At that time some of the rehabilitation patients visiting my rehabilitation department had suffered from neck pain for a long time because of cervical strain or previous cervical spine surgery. In those days, such … [Read more...]

A Painful Yarn part two

Continued from Eric's A Painful Yarn part one ......So, what did I notice? First, the adrenaline that accompanied the accident was wearing off. I could feel moment-by-moment discomfort and tension increasing in my right ankle and left knee as they swelled. I also got the sense that my body wanted movement. I found myself doing the proverbial … [Read more...]

A Painful Yarn part one

I was riding my bike on my normal route to work. Then it happened, like a blink. A jeep that was not supposed to be there was there, coming at me. No time to change course or apply brakes, just brace for impact. I was headed west bound on a two lane road. Entering a light controlled intersection on a green light.  A Jeep Cherokee in the opposing … [Read more...]

Should we turn away people with CRPS?

Two foods I love eating regularly (and that’s probably not a good thing for the latter) are tuna and ice cream. Thankfully, I have a firm grasp of the concept that some things just weren’t made for mixing. You might think this is a funny way to start a blog post on CRPS… but I promise you the Adelaide heat hasn’t fried my brain. I contend that … [Read more...]

Central Hypersensitivity in Chronic Shoulder Pain

Subacromial impingement syndrome is a common cause of shoulder pain that has multiple causes (subacromial bursitis to rotator cuff tendinopathy and full-thickness rotator cuff tears).  Unfortunately, for almost half of people afflicted with this syndrome, medical treatment is not successful and they will continue to have shoulder pain 2 years later … [Read more...]

Mind and machine: moving from rehabilitation to restoration?

Many futuristic movies and books depict humans with upgrades.  Extra limbs or special abilities are common and some even create a hybrid of human and machine as in Robocop.  This post will look at just how real that hybrid is and how technology and neuroscience are allowing this to happen. ‘60 minutes’ in the US recently showed a segment that … [Read more...]