Pain Management – it’s a sham

If we posit that pain is an output of the brain that is based on the perception of threat, it would follow that decreasing threat, whatever it may be, would positively influence a person’s pain experience. This has led to some exciting therapeutic advances aimed at altering threat, which include encouraging patients to rewrite their pain experience … [Read more...]

We should be worried about gravity?!?!

We all know how common back pain is and how back pain comprises a significant proportion of the 1 in 4 people with persistent pain. There is clearly an established link between the meaning of one’s pain and the fear it evokes, right?  Someone’s perception of what it happening in their back relates to their pain, right?  Castrophisation scales and … [Read more...]

Are cell-based therapies effective for low back pain?

In recent times, there has been a surge of interest in the use of cell-based therapies for the treatment of a range of musculoskeletal conditions, with many high profile sportspeople availing of these therapies (e.g here and here). Cell-based therapies can involve the use of chrondrocyte or mesenchymal stem cells. These are typically extracted from … [Read more...]

The role of interpretational style in children and young people’s pain experiences

Children and young people often complain about pain such as headaches, stomach aches, and muscle pain. However, as with adults, there is huge variability in how frequently the pains are experienced, how intensely they are felt, and how much control individuals have over the pain, to prevent it from being overwhelming and affecting everyday life. In … [Read more...]

Differences in central pain modulation between patients with chronic pain are important determinants of clinical pain status

Despite a better understanding of chronic pain during the last decade, treatment remains difficult and is often unsuccessful. Recent studies suggest that mechanisms of central pain modulation, (that is, mechanisms inside our central nervous system which can facilitate or inhibit our pain experience), play an important role in the development of … [Read more...]

Making Cancer Less Painful for Kids

New advances in cancer therapies have drastically improved the prognosis for children diagnosed with cancer. Forty years ago, children were only given a 58% chance of living 5 years after a cancer diagnosis. Today, that number as soared to over 80% of children surviving 5 years.[1] Children with cancer are living longer, and as a result, … [Read more...]

Get involved! Translating evidence into practice: Cognitive behavioural techniques for back pain

Translating research into clinical practice is a challenge for researchers in all fields. I work in the UK and funding bodies here appear to be keenly aware of this, and are increasingly providing opportunities to engage with this challenge through dissemination activities and improved research-clinician engagement, for example. Our group at the … [Read more...]

Painful Diabetic Neuropathy from a Bio-Psycho-Social Perspective

Painful Diabetic Neuropathy (PDN) is a complex and multi-dimensional condition that affects up to 20% of people with diabetes. PDN is associated with considerable morbidity, mortality and diminished quality of life (QOL). Unfortunately, pain treatment with medication in PDN is frequently unsuccessful or only partially successful [1]. Patients with … [Read more...]

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...]

Spinal manipulative therapy, Graston technique® and placebo for long standing non-specific mid back pain

Few controlled trials have assessed the efficacy of spinal manipulative therapy (SMT) for mid back pain. In addition no high quality trials have been performed to test the efficacy and effectiveness of Graston Technique® (GT), an instrument-assisted soft tissue massage therapy. The objective of this study was to determine the efficacy of SMT and GT … [Read more...]