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 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...]

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...]

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...]

First, do no harm

All the medics out there will be familiar with the third stanza of the Hippocratic oath: 'I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone'. The rest of us don’t have such an oath but I think we might need one. In the last three weeks, I have seen eight people with chronic, … [Read more...]

Brace yourself

Mary O'Keeffe

Despite the popularity of exercise programmes that emphasise “core stability” for the prevention and treatment of chronic low back pain (LBP), numerous high quality randomised controlled trials (RCT) (e.g. here, here and here) have not found them to be superior to other therapies such as general exercise. In fact, core stability exercise programs … [Read more...]

Can diagnostic uncertainty bias patients’ memory?

Danijela Serbic

Our thoughts shape our emotional and behavioural responses. This is a well-established principle in psychological research and Cognitive Behavioural Therapy. We use preconceptions – known as “schemas” - to help us filter new and ambiguous information. These schemas are helpful in many ways, but they do not always serve us well: they will often … [Read more...]

Weather Does Not Affect Back Pain

Everyone has a story about their back pain and one story you often hear is that the weather makes the person’s back pain worse. Topical now in Sydney as it is quite cold. We had an open mind on the issue because we had heard the story so many times but we also know that as a research question it was wide open as no-one had rigorously evaluated this … [Read more...]

Changing beliefs in the face of adversity: preoperative pain education tested

Here at BiM it’s no secret that we are very interested in pain education – so called Explaining Pain or EP. Using examples from current thinking in pain science, EP posits that the more one knows about their pain, and the less threatening one perceives their circumstances to be, the better the (actual) pain should be [1-3].  There is now strong … [Read more...]