Research into the role of the brain in chronic pain
Our research laboratory at the University of Alabama at Birmingham (UAB) in the United States has tested a distinguished form of physical therapy for persons with chronic walking difficulty from multiple sclerosis. The therapy is called Constraint-Induced Movement therapy, or CI therapy for short. The treatment was developed from years of basic … [Read more...]
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 … [Read more...]
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 … [Read more...]
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, … [Read more...]
I have had an interest in low back pain since the early stages of my career as a physiotherapist. My relatives, friends and patients complained about this condition and its recurrence even after receiving treatment. At that time, I was intent on finding a “cure” for this condition. I often browsed the literature to find the causes and possible … [Read more...]
This post is a republishing of a recent article in The Conversation by Michael Vagg:The announcement on Friday last week that pregabalin (Lyrica) made it onto the Pharmacutical Benefits Scheme (PBS) is a huge relief for sufferers of chronic nerve pain.It also means that the true cost of providing appropriate care to chronic pain … [Read more...]
Jack Nicklaus is on the short list of the greatest golfers of all time, and I love his evocative quote, “before every shot, I go to the movies.” He never hits the ball (not even in practice) without first having a very sharp, focused picture of it in his head. He constructs a detailed image of the green, every dimple on the ball, the trajectory … [Read more...]
When healthy people start to exercise, the brain activates powerful descending analgesic systems (pain inhibitory actions). This leads to increased pain thresholds during exercise, making it less likely that we will feel pain during, or immediately following, exercise. However, brain-orchestrated analgesia or pain inhibition is often impaired in … [Read more...]
While pain may be a universal experience, one experience that can often plague and frustrate everyone is that time when something works one moment but then all of a sudden doesn’t work the next. If you’ve ever had the pleasure of experiencing this you’ll find that it applies to many things in life whether it be the temperamental office … [Read more...]
Opioids. We all know what they are and that there are a lot of them going around, but it wasn’t until I was asked to write this blog on the information overloading review by Manchikanti and friends (2010) that I realised quite the extent. And to tell you the truth, it’s painfully scary!In a nutshell, well over half of the review pumped out … [Read more...]
In my general physiotherapy practice about one in five patients come with complex pain, disability and loss. I love sorting out the pieces of the puzzle that creates these situations. A challenge is not to get lost amongst all the pieces. So I take the patient on a journey of discovery as I find all the pieces, so I can then help them see their … [Read more...]
In the last post, I put Explaining Pain (EP) through its paces on the Burns test of 5 criteria that need to be met if we are to accept a theory of how a treatment works. Well, today I am going to put graded motor imagery (GMI) through the same test, just to give you all an idea on how far we have to go. As we point out in the Graded Motor … [Read more...]
The American Pain Society held its annual conference in Honolulu this year. I was fortunate enough to catch some of it. In the theme of blog posts about conference talks, started with our reflections on the NOI congress, this post is about a very interesting and enlightening talk I went to by the very impressive (on many counts) Jon Levine. … [Read more...]
The evidence for the role of exercise in chronic low back pain has been a bit of a theme on the blog here at BiM. We’ve discussed different perspectives regarding the evidence of its efficacy (see here, here and here), where it sits against other treatments in that regard and considered a recent review of its effects, or lack of, on parameters of … [Read more...]
We recently got an email from the guys at Neuro Orthopaedic Institute, or NOI as they are more commonly known. Now, none of us at BiM are part of NOI but we like the stuff they do and thought that this latest venture was worth giving a shout out for. The feedback we got from people who attended has been great. This is what they did.... Tom … [Read more...]
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