Research into the role of the brain in chronic pain
A trial of a very very very old treatment for tennis elbow just grabbed my attention. In fact the treatment in question probably precedes tennis itself. Yep, this is a trial of leech therapy for tennis elbow, proving the old adage that old treatments never truly die. The trial itself compared the application of leeches to the common extensor origin … [Read more...]
Some of you might have heard of repetitive transcranial magnetic stimulation (rTMS) and its use in chronic pain. Basically rTMS uses magnetic fields to generate electrical currents within the brain. This is a direct way of altering neuronal firing or excitability in the brain and a number of research groups have been investigating whether it might … [Read more...]
Body image means different things to different people. To many it refers to how one feels about one's body. To us, it refers to how one's body feels to oneself and how one perceives its shape, orientation, agency and ownership. Hopefully you can see that body image is critical to pain, because pain is, we reckon, necessarily felt in one's body. … [Read more...]
By Megan AuldIn research and in clinical practice, I’m forever finding myself snagged on the details – missing the story by getting caught up with p-values, forgetting that the arm I’m treating is connected to a head. Which is perhaps why I remember so clearly when Lorimer first persuaded me to focus on treating the source of the … [Read more...]
We have written a fair amount here about back pain. We’ve criticised some of the information patients get, shown how data has undermined many widely held beliefs about back pain (here and here), and acknowledged the rather desperate state of the evidence in terms of treatment efficacy. It is becoming more popular to see back pain as a problem of … [Read more...]
Mindfulness is, it seems, in fashion. Every month there seems to be a new TV show or talkback hour on its wondrous curative powers. It made it into our Christmas Dinner Conversation and I am waiting for the mindfulness-branded t-shirts and environmentally friendly canvas shopping bags to emerge. Is it really that good? Well, fortunately there … [Read more...]
We had a BiM team meeting on Tuesday, as we do every Tuesday. We got talking about the BiM blog - revisiting our objectives and how best to meet them. A key objective is to facilitate dissemination AND conversation. Well we have been well and truly trumped on that front by Jason Silvertail and his post for somasimple.com. Jason has taken a 'no … [Read more...]
What is it about some clinicians? They just seem to get great results by doing almost nothing! Could that be true? What is that elusive x-factor? Well, fortunately for us, Laura von Bertouch has agreed to tell us about a paper she does read that covers exactly that. Here is what Laura had to say:There is no doubt that sports and business are … [Read more...]
In reviewing 2010 for BiM, we wanted to gather together in one place the gems and nuggets that have been written in the last year.A big big THANK YOU to the 40 writers who have taken time out to explain their research and thinking as well as the many readers and commenters to the posts in various places on the interweb - the blog, facebook, … [Read more...]
Every now and then I stumble across a paper that evokes the reaction “I wish I’d though of that”. Such a paper recently turned up in the journal Rheumatology by Majid Artus and his colleagues at Keele University. They performed a systematic review that aimed to assess not the effectiveness of interventions but instead the overall pattern of … [Read more...]
When I remember primary school, I remember one of my teachers cutting snot out of his nose with a pair of scissors when he thought no-one was looking. When I remember high school, I remember teachers saying two things, mainly. "Lorimer, LORIMER, are you with us?" and "Well you certainly have a good imagination..." In fact, imagining things … [Read more...]
Having written a number of posts on acupuncture (see here, here, and here) I guess my particular biases are reasonably apparent. So imagine my surprise when a large RCT published in the journal “Pain” reports a significant and substantial effect of Chinese acupuncture in comparison with sham acupuncture or conventional orthopaedic therapy for … [Read more...]
I met a fellow called Max. He was impressive with his command of the facts. He does some cool studies. He's not one of the Luddies. And certainly not one of the hacks. That is what happens when one is a bit too low on sleep. Which I am. But Max is not. Max works in beautiful Oxford and has done some excellent work looking at the use of … [Read more...]
Some time ago, I wrote this paper, at the request of the journal Physical Therapy Reviews, on reconceptualising pain. It is a little old now but it has come to be a bit of a position paper. The position has four fundamentals, none of which will be very surprising to anyone I imagine:(i) pain does not provide a measure of the state of the … [Read more...]
We just came across a fancy patient information form that was given to a patient after an assessment by a clinician. The form just blew our minds (but not in a good way) because it seemed to be the perfect clinical tool for generating ongoing pain and disability, and all by the simple process of ramping up the fear. So, just for fun, we thought … [Read more...]
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