Expressing pain: which patients do we trust?

Trustworthiness is one of those instant judgements we automatically make about other people, affecting our behaviour towards them [1]. We wanted to know whether clinicians’ judgements of patients’ trustworthiness affected their estimation of patients’ pain [2]. There seem to be so many grounds on which the complaint and expression of pain is met … [Read more...]

Chronic Pain: Can we reduce long-term painkillers use?

In our recent review in PAIN, the journal of the International Association for the Study of Pain, we presented a provocative perspective on introducing dose-extending placebos in therapeutic plans to boost patients’ outcomes while reducing use of painkillers (e.g, opioids).  This was based on our (and others’) studies showing that placebos produced … [Read more...]

Long-term elbow pain: is the brain more at fault than the tendon?

Tennis elbow (known in medical terms as lateral epicondylalgia) is a common condition that presents with pain on the outer aspect of the elbow. Despite its name, the condition is not restricted to tennis players and can affect anyone performing repetitive movements of the forearm (manual labourers, typists etc). In fact, tennis elbow affects up to … [Read more...]

Pain Management – it’s a sham

If we posit that pain is an output of the brain that is based on the perception of threat, it would follow that decreasing threat, whatever it may be, would positively influence a person’s pain experience. This has led to some exciting therapeutic advances aimed at altering threat, which include encouraging patients to rewrite their pain experience … [Read more...]

We should be worried about gravity?!?!

We all know how common back pain is and how back pain comprises a significant proportion of the 1 in 4 people with persistent pain. There is clearly an established link between the meaning of one’s pain and the fear it evokes, right?  Someone’s perception of what it happening in their back relates to their pain, right?  Castrophisation scales and … [Read more...]

Are cell-based therapies effective for low back pain?

In recent times, there has been a surge of interest in the use of cell-based therapies for the treatment of a range of musculoskeletal conditions, with many high profile sportspeople availing of these therapies (e.g here and here). Cell-based therapies can involve the use of chrondrocyte or mesenchymal stem cells. These are typically extracted from … [Read more...]

The role of interpretational style in children and young people’s pain experiences

Children and young people often complain about pain such as headaches, stomach aches, and muscle pain. However, as with adults, there is huge variability in how frequently the pains are experienced, how intensely they are felt, and how much control individuals have over the pain, to prevent it from being overwhelming and affecting everyday life. In … [Read more...]

Differences in central pain modulation between patients with chronic pain are important determinants of clinical pain status

Despite a better understanding of chronic pain during the last decade, treatment remains difficult and is often unsuccessful. Recent studies suggest that mechanisms of central pain modulation, (that is, mechanisms inside our central nervous system which can facilitate or inhibit our pain experience), play an important role in the development of … [Read more...]

Get involved! Translating evidence into practice: Cognitive behavioural techniques for back pain

Translating research into clinical practice is a challenge for researchers in all fields. I work in the UK and funding bodies here appear to be keenly aware of this, and are increasingly providing opportunities to engage with this challenge through dissemination activities and improved research-clinician engagement, for example. Our group at the … [Read more...]

Painful Diabetic Neuropathy from a Bio-Psycho-Social Perspective

Painful Diabetic Neuropathy (PDN) is a complex and multi-dimensional condition that affects up to 20% of people with diabetes. PDN is associated with considerable morbidity, mortality and diminished quality of life (QOL). Unfortunately, pain treatment with medication in PDN is frequently unsuccessful or only partially successful [1]. Patients with … [Read more...]