Cognitive Functional Therapy for chronic low back pain: The patients’ perspective

Pain and lack of function are the two main factors that motivate people with non-specific chronic low back pain (CLBP) to seek care [1]. When you ask a person with CLBP what treatments they have tried, the answer is often in the form of a shopping list: manual therapy, stabilising exercises, Pilates, yoga, medication, injections… and so might the … [Read more...]

The Strange Case of Interoception and Resilience or How to Become a Superhero

Steel is a very resilient material: it has the capacity to absorb the energy produced by a hit without breaking. Translating this original definition of resilience into the Psychology field, a person is resilient when they can cope well with stressful situations. No wonder Superman is called “man of steel”! Back to more scienc-y stuff, recently … [Read more...]

How does parents’ chronic pain affect their children?

Parenting is a tough job. It’s hard enough when things are going well - imagine trying to parent while experiencing chronic pain. One mother with chronic pain, Sarah Erdreich, described her experiences with parenting her two-year-old daughter in a recent Slate article [1]. She described her worries about how her pain might affect her daughter, and … [Read more...]

Could telling right from left be a way forward in low back pain

Lately more and more research has indicated changes in cortical processing and disruptions of bodily representations in patients with low back pain (LBP). Among these findings, which have also been noted with other painful conditions, is impaired performance in laterality judgments [1,2]. While the exact relationship between LBP and laterality … [Read more...]

Body size of an embodied avatar modulates physiological response to pain

Nociceptive stimuli are processed through specific sensory pathways. Nonetheless, pain perception is highly subjective, and the amount of pain we feel depends on many things, including whether or not we are able to see the relevant body part. Indeed, looking at one’s own body reduces responses to pain, an effect known by the name “visual … [Read more...]

What’s best for chronic spinal back pain? Physical, behavioural/psychologically or combined interventions?

Non-specific chronic spinal pain (NSCSP), particularly low back pain (LBP) and neck pain (NP), results in significant personal, social and economic burden(here and here).[1,2] Our research group has recently published a systematic review and meta-analysis[3] in the Journal of Pain comparing the effectiveness of conservative interventions for … [Read more...]

Making decisions about activity when your back hurts

Participating in physical activity is an important part of recovering from low back pain. The fear-avoidance model is often used to explain the way in which people who have pain approach activity. This model proposes that when someone experiences pain they may either avoid movement and activity due to fear of further pain or injury, or they … [Read more...]

A plausible, alternate hypothesis for patient reports of asymmetries within the pelvis

The existence of positional faults of the intra-pelvic joints (sacroiliac joints, symphysis pubis) resulting in pelvic asymmetries remains a hotly debated topic amongst clinicians and researchers in the field of pelvic girdle pain. Check Chapter 46 in the latest edition of Grieve’s Modern Musculoskeletal Physiotherapy for some different takes on … [Read more...]

The impact of pain on motivation:  Should I stay or should I go?

Contemporary biopsychosocial models of chronic pain argue that the experience of pain emerges, and is influenced by, an interaction and integration of biological, psychosocial, and social factors.[1]  However, among scientists who study biopsychosocial models, the “bio” part of the model is often underdeveloped.  A greater understanding of how … [Read more...]

Pain may or may not inhibit (chronic low back) pain

In 2014 David Yarnitsky hypothesised that people may be characterised by profiles that vary from pro- to anti-nociceptive. Those with pro-nociceptive profiles would likely show a reduced capacity to enrol the body’s own pain inhibitory mechanisms, and heightened sensitivity to repetitive, painful stimuli. Those with anti-nociceptive profiles would … [Read more...]