Research into the role of the brain in chronic pain
Here at Brunel I run an MSc module on evidence based practice. In the first session of the module I run an honesty test. Here it is (answer it yourself and, well, be honest).“What sections of a research paper do you routinely read. Honestly.”Almost without exception the whole group will admit to reading the abstract and small proportion … [Read more...]
We’ve all wondered how to get our patients to change their life habits (to the better of course…in our minds). In fact, the behavioural and physical therapies depend on us being able to convince patients to develop new habits - to bend and straighten their knees a few times before getting up from prolonged sitting perhaps, or to walk up the … [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...]
Australia is, I think, the home of the Flat White - a coffee that is a bit like a latte with less milk and that has quite recently started infiltrating the UK coffee scene. Of course, Monmouth at Borough Market has been doing a very good flat white for a few years, but then again, in my view, Monmouth at Borough Market is the BEST place for coffee … [Read more...]
It seems like years ago now, well, it is years ago now, that I did this study with The Walking Cortex (TWC, Paul Hodges). This was one of my PhD studies. I think it is quite a groovy study. We gave supposedly normal healthy volunteers painful electric shocks, through electrodes placed over the back of their pelvis. We showed that when they … [Read more...]
When I went through physio school, I remember feeling more and more aware of how I sat, as the course went on. We were clearly learning our stuff - we knew, that back pain was caused in no small part by discs bulging - HANG ON! Let me start at the beginning (for as Mary Poppins says, it is a very good place to start). We actually knew that the disc … [Read more...]
There is a really attractive theory that has been used to explain why some people have chronic ongoing pain even though there is nothing wrong in the body part that hurts. The theory suggests that the pain occurs because motor commands don't match proprioceptive feedback from the body. The name often given to this theory is the sensory-motor … [Read more...]
There is a very clever Belgian psychologist called Stefaan Van Damme. He has done some excellent work on attentional mechanisms involved in pain. More importantly, however, is that he is a jolly nice fellow. Anyway, he came to Oxford and did a great little experiment (actually, we did a couple but the other one is not ready for the real world … [Read more...]
One really cool aspect of using a software program like Recognise, is that you can keep tabs on whether or not patients actually do what we ask them to do. This is an important issue because any treatment that involves home exercises or training depends on people doing it! Historically, clinicians have used a training or home exercise diary to … [Read more...]
Chronic pain is associated with a loss of the normal capacity to know where your body is. Chronic pain is also associated with odd bodily feelings. To find out if people with chronic back pain had trouble 'feeling' their back, they were asked to draw on a piece of paper the outline of where they felt their back to be. This is a bit tricky to … [Read more...]
Often, when you publish something in a reasonably posh journal, your mates write you a little email to say congratulations. However, if you write a word like 'daft' in an article that is published in a posh journal like BMJ, it is not just your mates who say congratulations! I got about 40 emails from people I have never heard of over this one. … [Read more...]
G. Lorimer Moseley Department of Physiotherapy, The University of Queensland, and Royal Brisbane & Women’s Hospital, Brisbane, Australia.AbstractBackground: People with complex regional pain syndrome (CRPS) take longer to recognize the laterality of a pictured hand when it coincides with their affected hand. The author explored two … [Read more...]
G.L Moseley Department of Physiotherapy, University of Queensland, Australia Department of Physiotherapy, Royal Brisbane Hospital, Brisbane, Australia Abstract This paper presents an approach to rehabilitation of pain patients. The fundamental principles of the approach are (i) pain is an output of the brain that is produced whenever the brain … [Read more...]
G Lorimer Moseley School of Physiotherapy, The University of Sydney, Sydney, Australia Abstract Regional anesthesia results in shrinkage of the primary sensory cortex (S1) representation of the area and the perception that the area is larger than it is. Complex regional pain syndrome type 1 (CRPS1) also involves shrinkage of S1 representation … [Read more...]
Up close and personal with movement – a review from the experts
Here is a review that, if you are interested in how the brain controls muscles, and you are prepared to put in some hard yards, you should read. Simon Gandevia works down the corridor from me, so do Janet Taylor and Jane Butler. Nicholas Peterson doesn't but I once had a cup of tea from the same pot. So, I am, everyday, in the presence of … [Read more...]