Overhauling the design of psychological treatments for pain: Time for a radical change?

Morley and colleagues[1] recently conducted a topical review that focuses on meta-analyses for evaluating psychological treatments for chronic pain. I enjoyed reading this opinionated and somewhat strongly worded call to, in short – do better. Published in one of the premier journals in the field, PAIN, the authors are quite bold in their … [Read more...]

Subgrouping patients with chronic whiplash on the basis of symptoms of sensory hypersensitivity and PTSD

Ash Pedler

A significant proportion of people (up to 50%) who develop neck pain following a car accident continue to report neck pain at long term follow up. It's not clear why these patients don't recover and unfortunately current evidence seems to indicate that usual rehabilitative management is not very effective for patients with chronic whiplash. The … [Read more...]

Spinal manipulative therapy: a slow death by data?

Neil O'Connell 2

I am a recovering manual therapist. In my physio career I have moved from freshly qualified apprentice, eager to learn the secrets of what was sold as a powerful tool, particularly for spinal pain, via what might be classed as a skilled practitioner, certainly in terms of courses attended and assessment hoops jumped through, to someone who now … [Read more...]

Should we train deep trunk muscles to improve the clinical outcomes of low back pain?

Transversus abdominis (TrA) and lumbar multifidus (LM) are two deep trunk muscles implicated in maintaining spinal stability at rest and during physiological movements. A number of research studies have found that people with acute, chronic or recurrent low back pain (LBP) show abnormal changes in the physical characteristics (e.g. shape, … [Read more...]

The fascia and back pain – What does a chemical stimulation tell us about it?

Andreas Schilder

Back pain is a worldwide problem causing time lost from work, disability and economic cost. Over 75% of humans suffer from back pain at least once in their lifetime and the yearly prevalence of the working population is 8%, where the lower back represents the most mentioned region. Disorders of osseous structures, disc herniations or nerve root … [Read more...]

Acupuncture and awareness

We have just published the results of a small experiment looking at acupuncture in people with chronic low back pain (see here). Now that is not a sentence I thought I would ever write, so there is some explaining to do. Acupuncture is a common treatment for back pain and one that has been well researched. The outcome of this research effort is … [Read more...]

Low back pain: does shoe type make a difference?

Sian MacRae

Low back pain effects up to 80% of the population at some point in their life time. Although national and international guidelines recommend exercise therapy as a best practice in the management of chronic low back pain (pain that has been present for 3 months or greater) the long term benefits of exercises to people with low back pain are minimal. … [Read more...]

Chronic Pain: Lost Inhibition?

While working with chronic neuropathic pain sufferers over the last few years, quite often I was asked if there is a “pain center” within our body, particularly in the brain, where pain is generated. One of my chronic pain patients actually quipped: “If you tell me where the pain hub is I will go to a surgeon and let them cut it out”. … [Read more...]

Illusory Perceptions

Postman Pat

A person, let’s say his name is Pat, views a staircase in front of him; he is delivering a parcel (Postman Pat) and must climb three flights of stairs to deliver it to flat 15. Pat has knee pain and stairs aggravate his pain. Just as Pat is surveying the stairs, a (pain-free) resident sidles passed him and makes his way up; Pat follows behind him. … [Read more...]

Baby love, my baby love

The Journal of Pain recently announced the five most downloaded articles of 2013. Our very own Jane Bowering was on the podium with the third most downloaded paper (and the second most read paper in the Journal's history!!) Well done indeed Jane! Anyway, we have decided to bring all five of the most downloaded articles to you over the coming weeks. … [Read more...]