Communication and chronic low back pain; are there lessons from Aboriginal Australians?

Ivan Lin

“I can’t really understand ‘em” (Middle aged Aboriginal man with chronic low back pain) Have you ever heard someone say this or words of similar effect after they have seen a health practitioner such as a doctor, surgeon, physiotherapist or chiropractor for treatment for low back pain? Have you ever experienced this feeling yourself as a … [Read more...]

A clash of beliefs: why our Western approach to pain didn’t work in a rural Zulu community

Graduating as a health professional can be both exciting and daunting. When we first qualified as physiotherapists, we couldn’t wait to get started. We were sent to a beautiful, rural, remote area of South Africa where we started clinical work under minimal supervision. But it was not long before we found ourselves out of our depth and wondering … [Read more...]

How do I love thee? One size does not fit all

Pain is often considered a personal experience, but is in fact rarely private. Pain occurs in and is shaped by an interpersonal context. Specifically, pain grabs the attention of the person in pain and also – through expressive behaviours - the attention of others in their environment. In turn, how the observer responds impacts upon the sufferer’s … [Read more...]

NIH Task Force on Research Standards for Chronic Low Back Pain

Official photo-Deyo.

In 2009-10, the NIH Pain Consortium convened two workshops on chronic low back pain, noting that researchers use varied inclusion criteria, definitions, baseline assessments, and outcome measures. Such variation impedes our ability to compare studies, replicate findings, pool data, resolve conflicts, and achieve consensus. It was recommended that … [Read more...]

Which is the best treatment for an individual with back pain

Martine Barons

Low back pain is a very common problem and there is no known cause for the majority of cases. In clinical trials, many treatments seem to offer small, short-lived effects but no treatment comes out on top. In our paper [1], we are interested in which treatment is most likely to be effective for a particular individual. For this we used data from … [Read more...]

First, do no harm

All the medics out there will be familiar with the third stanza of the Hippocratic oath: 'I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone'. The rest of us don’t have such an oath but I think we might need one. In the last three weeks, I have seen eight people with chronic, … [Read more...]

Elite athletes are human too

Putting the Sydney Swans dasher Gary Rohan through the ‘credible evidence of danger and safety’ test I have taken most of an article published in Melbourne’s The Age, and Sydney’s  Morning Herald, in the lead up to the Australian Football League’s Grand Final, where my team, the Sydney Swans, are taking on last year’s champions, the Hawthorn … [Read more...]

Is pain the same in boys and girls

Katelynn Boerner

The differences in the ways that boys and girls are expected to react to pain has long been the subject of folk wisdom and cultural idioms: Boys are expected to “tough it out” and “take it like a man”, while expressions of pain in girls are accepted and sometimes even encouraged. But are societal expectations of how boys and girls should react to … [Read more...]

Brace yourself

Mary O'Keeffe

Despite the popularity of exercise programmes that emphasise “core stability” for the prevention and treatment of chronic low back pain (LBP), numerous high quality randomised controlled trials (RCT) (e.g. here, here and here) have not found them to be superior to other therapies such as general exercise. In fact, core stability exercise programs … [Read more...]

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...]