It worked before but now it doesn’t? Graded Motor Imagery in Clinical Practice

at least I work now

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 photocopying … [Read more...]

The Opioid Bank. It seems we are facing another global crisis!

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...]

Pain assessment flowchart. Patient, practitioner and environment

David Young Physiotherapist

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...]

Does graded motor imagery satisfy the Burns test?

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 Imagery … [Read more...]

His and hers opioids – one size does not fit both

Jon Levine

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.  There … [Read more...]

More fragility in core stability

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...]

Graded motor imagery, one shark and two men on a mission

noi group Tom Giles and Tim Beams

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 Giles … [Read more...]

Tennis elbow? You’re bleeding me dry!

leeche therapy

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...]

rTMS and chronic pain: Our two penny’s worth

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...]

Just a heartbeat away from one’s body

Manos Tsakiris

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...]