Quantitative Sensory Testing in Chronic Musculoskeletal Pain

Introduction Our recent review, published in “Pain Medicine”, highlighted the measurement properties of quantitative sensory testing (QST) and its clinical utility. QST results have been shown to be related to pain or neural sensitivity. QST has been put forward as a potentially useful tool for monitoring disease prognosis and evaluating … [Read more...]

“Encontros Saúde & Dor” Bringing Pain Education to Low-Income Communities in Brazil

Approximately 11.25 million Brazilians live in low-income communities or “favelas.” In my home town of Jundiaí, near São Paulo, there are no less than 14 of these low-income communities, the largest of which houses approximately 15 000 families. Some low-income communities, such as Rocinha in Rio de Janeiro, are home to up to 180 000 people. At … [Read more...]

The false promises of shared decision making in rehabilitation

In the recent years, Shared Decision Making (SDM) has been increasingly advocated as an ideal model of treatment decision-making during the medical encounter, as it has been shown to increase benefits for both clinicians and the health-care system (1).  But does SDM result in better outcomes for patients with painful musculoskeletal conditions?  In … [Read more...]

Could Virtual Reality Dodgeball motivate fear-avoidant CLBP patients to move? Implications for future treatment.

Chronic low back pain (CLBP) is one of the most common musculoskeletal conditions health care professionals encounter. Unfortunately, despite ever increasing costs in regards to clinical management, the results remain underwhelming[1,2] giving CLBP an enigmatic nature. As a masters student I am interested in understanding how the neuromodulatory … [Read more...]

The phantoms in our dreams

Ask yourself for details in your latest dreams and you will recognize how hard it is to recall your own dream content in a precise and valid manner. In William Shakespeare’s world-renowned tragedy ‘Hamlet’, the protagonist says ‘a dream itself is but a shadow’, emphasizing the transience of this cognitive phenomenon. As such, dreams hardly lend … [Read more...]

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...]