Occasionally, very occasionally, Heidi will show me something on youtube (or one of those Heidi-type sites) that is really very good. And this really is very good. The graphics are superb. The coverage of material is excellent. It is faithful to the evidence. It is engaging and it is narrated by an Australian. These are all, in my view, … [Read more...]
Acupuncture, some dodgy maths and a cracking review paper
December 6, 2010 by 49 Comments
I have a challenge for you. Imagine you’re in ancient China and you’ve had this idea that health and disease hang on the flow of energy through invisible energy pathways called meridians that can be manipulated by applying needles in certain specific points. How do you go about systematically validating this theory? How do you know where the … [Read more...]
Placebo effect: now we can see it, but should we believe it?
December 2, 2010 by 7 Comments
Placebo effects are a great way to start a conversation, particularly if one is at a Clinical Trials Festival. Rather than being fascinated by the possibilities of the brain's internal capacities to influence its own outputs, some believe placebo effects are a nuisance and something to either ignored or removed. Well, as you will see from this … [Read more...]
Taking clinical neuroscience to the people. An update.
November 25, 2010 by 9 Comments
For those of you who don't know the odd life of a scientist, here is a little window: I am an NHMRC research fellow. This means that once every few years I stick my CV in front of a panel of scientists who have to decide if I am worth paying for another few years. A big part of that decision comes down to my 'impact'. Historically, impact has … [Read more...]
Belgium – Famous for Chocolate and Explaining Pain Biology
September 21, 2010 by 2 Comments
Not an immediately obvious pairing, but still a bit more logical than a shop I once visited in UlaanBataar that sold saucepans, fur coats and guns (actually now that I think about it - one could shoot the elk, skin it and cook it up - quite the sensible shop after all). These Belgians have taken on the explaining pain thing and done some very nice … [Read more...]
Teaching people about pain – a kind of position paper
August 23, 2010 by Leave a Comment
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...]
Anxiety and mood in people with fibromyalgia or neuropathic pain – different mechanisms
August 10, 2010 by 3 Comments
Professor Troels Jensen's clever group of researchers have published an interesting paper in the European Journal of Pain. We were thinking about writing a little spiel on it so you can get the idea and then we thought - what about asking the authors? So we did. Fortunately for us, Lise Gormsen, who has now got her PhD via this work, kindly … [Read more...]
Is CRPS an auto-immune disease
August 3, 2010 by 5 Comments
Intravenous Immunoglobulin in Complex Regional Pain Syndrome Andreas Goebel on the results of his latest clinical trial .Just imagine the causes of some chronic pains are completely different from what you had thought. Complex Regional Pain Syndrome is a severe pain which persists after limb trauma. You are unlucky if you develop this nasty … [Read more...]
The morality of magic kisses: Ethics and placebo in physiotherapy
July 26, 2010 by 16 Comments
When my daughter hurts herself, her placebo of choice is a “magic kiss”. This therapeutic intervention must be applied with care specific to the area of injury. Anecdotal evidence suggests that it is very effective. I use placebo freely at home but is it right to do this in the clinic? In a recent post I suggested that we can be more confident … [Read more...]
What did you expect?
July 22, 2010 by 5 Comments
Hands-up who thinks a patient’s expectations influence how well they do in treatment? By Steve KamperNearly everyone? That’s no surprise. Research recently published by a group in the US reported on the relationship between expectation and outcome in a sample of back pain patients receiving physiotherapy. This is by no means the first time … [Read more...]
We Believe Because We Evolved That Way part two
July 20, 2010 by 2 Comments
Why we have a placebo effect - Part II By Peter Blanch continued....Bruce Hood (Hood 2009) in his book “Supersense: why we believe in the unbelievable” makes a couple of quite pertinent points. He outlines a simple experiment he uses in his presentations where he presents to the audience ‘the pen’ (he admits to stretching the truth … [Read more...]
We Believe Because We Evolved That Way part one
July 19, 2010 by 9 Comments
Why we have a placebo effect - Part I By Peter BlanchFor a long time now, I have stood with my feet precariously placed on two icebergs that sometimes slowly drift apart and sometimes drift back together again (obviously increasing and decreasing my sensation of precariousness). The first iceberg is where I started as a clinician, with both … [Read more...]
Paul the Psychic Octopus: A watery lesson in understanding clinical evidence
July 15, 2010 by 2 Comments
So the World Cup justifiably goes to Spain and it seems that Paul, the now world famous psychic octopus, predicted the results. In fact Paul demonstrated a seemingly legendary clairvoyant ability. Wikipedia informs us that he predicted the outcome of all of Germany’s games and the final with unerring accuracy. You may not have realised it … [Read more...]
The Riddle Winner
July 10, 2010 by 2 Comments
Some time ago (Heidi says 'in the dim distance past') we ran a riddle about this photo:There were two prizes - for the correct explanation and for the answer we like the best. Well, surprise surprise, NO ONE got it correct. There were bits that were close. You will see how difficult it is to get it correct when you read the correct … [Read more...]
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