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...]

A lack of variability in people with pain? I’m intrigued…

A recent paper by Falla and colleagues [1] evaluated back muscle activity (via electromyography) during a repetitive lifting task and compared two groups: a chronic/recurrent low back pain group and a healthy control group. What is unique about this study is that they evaluated back muscle activity using a grid of electrodes to characterise the … [Read more...]

Is one question enough to screen for depression and anxiety

Silje Reme

Psychological factors, such as depression and anxiety, are significant contributors in the transition from acute to chronic pain. A person suffering from acute low back pain with additional symptoms of anxiety and/or depression has a higher risk of becoming a chronic pain patient than a person without these additional symptoms. Furthermore, … [Read more...]

Can low back pain be influenced by pain in the front of the body?

John Panagopoulos

As a physio who works in a busy clinic and treats lots of different people, one of the phenomena that I’ve observed over the years is how many patients, who present with back or neck pain, and also mention they have lots of gut / reproductive problems. These gut problems are generally mild symptoms like feeling bloated and constipated. Even when … [Read more...]

Low-back pain, a consequence of cumulative mechanical loading?

Jaap van Dieen

In a recent reaction posted on this website, it was stated that systematic reviews typically find little or no relationship between physical loading and low-back pain. The author cited three reviews, seemingly providing solid evidence in support of this statement. However, these reviews are part of a series produced by the same group, according to … [Read more...]

Risk Factors for Low Back Pain

Jeffrey B. Taylor

As with most orthopaedic injuries, the greatest risk factor for developing low back pain (LBP) is a history of low back injury. Because of this, an initial injury to the lumbar spine may develop into a long history of dealing with recurrent bouts of pain and reduced function that emanate from a spine injury. Therefore, investing in intervention … [Read more...]