Get involved! Translating evidence into practice: Cognitive behavioural techniques for back pain

Translating research into clinical practice is a challenge for researchers in all fields. I work in the UK and funding bodies here appear to be keenly aware of this, and are increasingly providing opportunities to engage with this challenge through dissemination activities and improved research-clinician engagement, for example. Our group at the … [Read more...]

Painful Diabetic Neuropathy from a Bio-Psycho-Social Perspective

Painful Diabetic Neuropathy (PDN) is a complex and multi-dimensional condition that affects up to 20% of people with diabetes. PDN is associated with considerable morbidity, mortality and diminished quality of life (QOL). Unfortunately, pain treatment with medication in PDN is frequently unsuccessful or only partially successful [1]. Patients with … [Read more...]

Giving patients the whole truth

I am guilty of being the eternal optimist in my practice. I can’t recall ever telling a patient that the outlook isn’t great for them, even though on many occasions, I had that sinking feeling in my gut. Many patients in pain are distressed enough – they don’t need me to give them more to worry about, do they? Maybe I’m not the only clinician who … [Read more...]

Spinal manipulative therapy, Graston technique® and placebo for long standing non-specific mid back pain

Few controlled trials have assessed the efficacy of spinal manipulative therapy (SMT) for mid back pain. In addition no high quality trials have been performed to test the efficacy and effectiveness of Graston Technique® (GT), an instrument-assisted soft tissue massage therapy. The objective of this study was to determine the efficacy of SMT and GT … [Read more...]

Why physical therapy treatments for low back pain may not be living up to their potential

Low back pain (LBP) is a leading contributor to people living with disability throughout the world,1 and the problem appears to be getting worse rather than better.2 Scientists and clinicians, therefore, need to improve treatment for LBP to shift this trend and reduce disability. People with LBP change how they control their posture for … [Read more...]

Diagnostic uncertainty and pain-related guilt: new treatment targets for low back pain?

Low back pain (LBP) is a highly prevalent condition, with a devastating impact on society and it is now recognized as the leading cause of disability worldwide (Lim et al., 2012). Research suggests that several psychological factors play an important role in LBP, and among the most robust factors are depression, catastrophic cognitions, fear of … [Read more...]

Low Back Pain Treatment in Primary Care

In general, most acute low back pain (LBP) recovers spontaneously within a few days or weeks. No active treatment has shown to actually shorten the time it takes for acute back pain to recover. The purpose of medication, manipulation, acupuncture, physiotherapy etc. is at best to ease the pain while one is waiting for nature to heal. And one should … [Read more...]

The enduring bond between chronic back pain and sleep disturbance: not a love story

Intuitively, one expects that pain, whether acute or chronic, will affect sleep quality. However, the relationship between pain and sleep is not fully understood. Pain has been widely reported to be associated with various measures indicative of sleep disturbance including reduced sleep efficacy, reduced total sleep time, delayed sleep onset, … [Read more...]

Common psychologies in back pain?

Numerous psychological factors are associated with chronic low back pain (CLBP) and disability. Clinically, it would appear that the psychological profiles of individuals with CLBP can be dominated by different psychological factors. For example, some people are significantly depressed while others might exhibit strong fear-avoidance beliefs. In … [Read more...]

Cognitive Functional Therapy for chronic low back pain: The patients’ perspective

Pain and lack of function are the two main factors that motivate people with non-specific chronic low back pain (CLBP) to seek care [1]. When you ask a person with CLBP what treatments they have tried, the answer is often in the form of a shopping list: manual therapy, stabilising exercises, Pilates, yoga, medication, injections… and so might the … [Read more...]