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...]

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...]