What underlies fear for movement in people with low back pain?

Sam Bunzli

“I would never bend over to pick something up. I try to brace myself on any move. Because every time time it hurts I think that I’m doing more damage. Every time it hurts I think it is getting worse and I am breaking down, I am killing myself…” (John, a 42 year old school teacher who has experienced back pain for 2 years). “I don't think that … [Read more...]

Pain communication through body posture: The many postures of pain

Joe Walsh

Pain is not just a sensory experience. Of course, there is a key biological element to pain, but there is also a much broader range of factors that may influence how we perceive threatening events and noxious stimuli and may feed into the pain experience. An important factor that influences our pain perception is the social context in which we … [Read more...]

Pain and mortality in older adults, what is the relationship?

Rachael Docking

In those of working age there is a known association between pain and increased risk of mortality (excess mortality) for both men and women. Macfarlane et al (2001) found that adults with regional/widespread pain were at increased risk of mortality in the 8 years following onset, and these deaths were predominantly due to external causes (such as … [Read more...]

Can’t reduce your pain? Try a different way!

Hadas Nahman

Our nervous system has the capability to reduce pain by activation of specific pathways that exert inhibitory effects on the messages entering the central nervous system during or after threat or damage to the body. This is called endogenous analgesia. Several paradigms can be used to test its capacity and evaluate its efficiency. One paradigm, … [Read more...]

What does tDCS do for pain?

Arne May

We’ve heard a lot about non-invasive electrical brain stimulation recently (e.g. Body in Mind blog post tDCS – negotiating the 'rising tide' of hype), but does it really work for chronic pain? Well, some people who conducted trials in chronic pain populations claim it does [e.g. 1–5], but taking a closer look at the evidence is disappointing: the … [Read more...]

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...]