How Risky is the Pain Treatment I am Considering

Matthew Hunsinger

When a medical practitioner prescribes a medical treatment for pain, one of my first questions is whether there are side effects or other potential risks. I contend that every pain treatment is inherently risky; the question is how much risk is associated with a particular treatment. Most of us probably rely on the medical practitioners with whom … [Read more...]

No man is an island

Sam McLean

Living in a disadvantaged neighborhood influences chronic pain development after motor vehicle collision, and this effect is moderated by a common genetic variation that influences HPA axis function. We all like to believe that we are impervious to our surroundings. It’s reassuring to feel that we are “captain of our own ship”, charting our own … [Read more...]

What central pain processing mechanisms could be responsible for the development of poor pain scores

John Barbis

When patients do not improve after surgery, the search for an answer can be complex and often disappointing. Valencia et al, in a well-performed, rather complex study, try to tease out the components of that answer [1]. Their study tries to determine what central pain processing mechanisms could be most responsible for the development of poor pain … [Read more...]

David Sackett Talks About Evidence Based Medicine

Another in our Golden Oldies series:  Here is a superstar, well I guess he is sort of a pioneer/superstar, of evidenced based medicine, in an interview with a slightly cheesy fellow, just after Sackett won the Gairdner Award for Leadership in Medicine. These awards are extremely posh and Prof Sackett deserves it. The thing I like about him is him … [Read more...]

Acupuncture and a cracking review paper

Going over the archives, Neil wrote this after finding a  review paper written by Professor Donald Marcus "Is Acupuncture for Pain a Placebo Treatment? An examination of the evidence".  First published in The Rheumatologist, it is open access - which means you can read the full paper for free. Acupuncture, some dodgy maths and a cracking review … [Read more...]

Making sense of research and helping it guide our practice

Another in our golden oldie series celebrating BiM's 5th birthday since it published it's first blog post on 17th August 2009.  This one by Neil O'Connell. A sparkling, glittery threat to evidence based practice 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 … [Read more...]

Learn something novel every decade

Sculpture Univeristy of Stuttgart

Newly edited we first published this blog post in 2010 just after the new year, now the text is freely available (see reference at the end of the post).  This is another in our golden oldies series. Further evidence to suggest we should learn something novel every decade I remember sitting my folks down and sternly counselling them to make … [Read more...]

Chronic Pain: Lost Inhibition? PART TWO

In our last blog (Chronic Pain: Lost Inhibition?) we talked about the role of the thalamus in the development and maintenance of orofacial neuropathic pain. We reported that painful trigeminal neuropathic pain (PTN) is associated with altered thalamic anatomy, function and biochemistry, which may disturb central processing and play a key role in … [Read more...]

Can diagnostic uncertainty bias patients’ memory?

Danijela Serbic

Our thoughts shape our emotional and behavioural responses. This is a well-established principle in psychological research and Cognitive Behavioural Therapy. We use preconceptions – known as “schemas” - to help us filter new and ambiguous information. These schemas are helpful in many ways, but they do not always serve us well: they will often … [Read more...]

But they walked, hopped and jumped on it!

From the days of my infancy as a physiotherapist, I was raised on the teaching that pain should be measured by subjective means only. You have to ask the patient. You cannot presume to judge the magnitude of their experience: you ask them, and they tell you. If they say it’s a 2 out of 10, that’s what it is. If they say it’s an 11 out of 10 (I see … [Read more...]