Research into the role of the brain in chronic pain
Keeping up to date in chronic back pain research is a busy process and yet it is rare that a new paper really catches the eye. A while back a trial of methylene blue injections appeared to demonstrate surprisingly impressive results. I blogged on it (here) and mused on how results that good really need to be independently replicated before we can … [Read more...]
Most commonly used exercise therapies for back pain are aimed at having an effect on some mechanical or tissue based aspect of spinal function. From range of motion exercises to muscle balance, endurance or strengthening exercises the (not unreasonable) rationale is that back pain is associated with abnormal spinal function - address that with … [Read more...]
In recent years there have been many debates about the disappointing results from clinical trials of treatments for non-specific low back pain. One argument has been about the targeting of treatment for back pain. Many folk have argued that trials which apply a one-size-fits-all treatment fail to show a reasonable effect because amongst those who … [Read more...]
For my first BIM post I wanted to blog about an article that I read some years ago that had probably the biggest impact on my thinking on low back pain and disability and 15 years later still informs the way that I think about pain and disability.Around the mid 1990s when I first started research in low back pain a UK-based health psychologist … [Read more...]
I have just come across an intriguing paper in Psychological Science by Travis Carter and his mates in Chicago. They did an experiment in which Americans who were filling out political surveys did so with either a small American flag in the corner of the screen, or nothing in the corner of the screen. They analysed the participants’ responses … [Read more...]
I’m not a vegetarian. Perhaps that understates the issue, I am a fundamentalist carnivore and the idea of a barbeque without sausages and burgers is to me an unconscionable aberration; an affront to common decency. Just be honest and call it a salad party….and then don’t post my invitation.Just as the missing meat at a barbeque is a … [Read more...]
Reduction in pain and disability with a graded sensorimotor retraining program in chronic back painOur team recently returned home from Darwin, where we all attended the Australian Pain Society’s Annual Scientific Meeting. We all presented some of our work up there and had a lot of fun while we were at it. I presented a poster, based on … [Read more...]
Quick reminder from last post: The aim of our study[1] was to evaluate the assumptions that were made when translating the individual study criteria[2-6] (eg, all the criteria from the original subgrouping studies) into the classification algorithm.To evaluate the impact of these changes made to the individual study criteria, we recruited 250 … [Read more...]
The email from the industry was effusive. In a cock-a-hoop, caps lock-happy frenzy it bellowed “ALL MANUAL MEDICINE PROVIDERS SHOULD BE AWARE OF THIS STUDY”. The study in question, soon to be published in the journal “Spine” is a RCT that specifically looks at whether patients with chronic back pain benefit from a sustained period of … [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...]
Is it possible that a lack of centralisation reflects a predominance of centralisation? Well, the undisputed wrestling champion of physical therapy is wrestling with this very topic, having been motivated by an intruiging paper. Fortunately for BiM, John kindly agreed to write a post on it. Here it is:Here is a riddle for you. What word by … [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...]
I’m a little late to this one but an interesting disagreement recently emerged in the letters to the editor in the journal Pain. This focused around a recent study from the impressive Arthritis Research Campaign National Primary Care Centre at Keele University, UK into the psychological obstacles to recovery from low back pain.The study … [Read more...]
It is tempting, in research, to apply the normal rules of summation - where adding one treatment that you think is effective to another treatment that you think is effective should give you a combined treatment that is more effective than either. However, as Cormac Ryan from Glasgow Caledonian University points out, it does not necessarily work … [Read more...]
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