Beyond Balance: outpatient opioid taper without pain increase is possible

Opioid policy debates are often framed in terms of balancing opioid risks with chronic pain relief. This assumes, not only that opioids provide long-term pain relief, but that opioids are necessary for pain relief. Based on our many years’ experience with successful opioid dose reduction in our structured multidisciplinary pain rehabilitation … [Read more...]

Can fear of movement lead to physical inactivity in low back pain?

It’s well known for most health professionals who regularly treat patients with back pain that often patients are afraid of moving because they believe that movement will cause further pain and injury. This fear of movement, and belief that physical activities will cause (re)injury, is the central concept of the well-known Fear-Avoidance Model. … [Read more...]

A new method of assessing women with pelvic pain

Are you female? Do you know any females? Chances are, the majority of you are thinking ‘yes’. And chances are, the majority of those females you know have experienced pelvic pain. Almost every woman will experience pain during menstruation (dysmenorrhoea) at some point during her life[1] – and usually it seems like some kind of uterus-driven … [Read more...]

“I need to do another course” – Physiotherapists’ views on assessing psychosocial factors in chronic low back pain

Psychosocial factors (PS) are described as the combination of an individual’s cognitive, emotional and social status that can influence their health status (Singla et al., 2015) and they include: patients’ beliefs that pain and activity are harmful, fear avoidance beliefs, negative behaviours, lack of support, overprotective families, physical … [Read more...]

Restoring movement representation with virtual reality alleviates phantom limb pain

Working hypothesis about phantom limb pain and movement representation Patients with phantom limb pain (PLP) may report altered movement representations of their phantom limb, for example, ‘my phantom limb is frozen in one or more peculiar positions’. Dr. Sumitani previously reported that visual feedback using a mirror restored the voluntary … [Read more...]

Is “how much?” the right question to ask about exercise for pain?

  Exercise is widely accepted to be beneficial for health and is increasingly prescribed as treatment for many diseases and other chronic health conditions. Many studies in both humans and rodents have investigated the effectiveness of exercise as a treatment for chronic pain. Although the efficacy of exercise in rodent models of persistent … [Read more...]

All Fatigue is Not Created Equal: Why it Matters, and What it Means for Pain Management

Have you ever felt so tired that you wished you could hibernate? Or so out of energy that you wanted to plug into a wall outlet and recharge?  Even if you haven’t, you’ve probably experienced the fatigue of a long day at work, a workout, or a poor night of sleep. This feeling is not only physical; emotional and mental fatigue can lead to … [Read more...]

Paracetamol for acute low back pain – a cheap fix or a waste of health resources?

Many of us have the humble paracetamol pill in the cupboard at home, and reach for it when we experience pain. But recent research shows that paracetamol does not provide more pain relief than a placebo pill in low back pain and osteoarthritis [1]. A more detailed way of explaining this is that paracetamol does not provide extra pain relief for … [Read more...]

Changing pain thresholds with classical conditioning

Our previous post about a classical conditioning model for pain generated some lively discussion.  Some argued vehemently that pain cannot be a classically conditioned response, and others argued vehemently that of course it can and we have known this for decades.  We haven’t yet pinned our colours to any particular mast – we’d like to see the … [Read more...]

Chronic pain can be lessened by an ‘out of body’ illusion

If you’ve ever heard of stories in which people report having an ‘out of body experience’ (OBE) during a traumatic incident like a car crash you might be able to guess why there could be a link between OBEs and chronic pain. Some scientists have suggested that the very vivid hallucination that is an OBE can sometimes serve an adaptive function by … [Read more...]