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...]

Which treatments for which patients?

Adam Hirsh

How do clinicians decide which treatments to provide to which patients? One might assume a simple process: if patient X has condition Y, treatment Z is provided. For many conditions, it is this straightforward – treatment guidelines are clear enough to remove any guesswork. Unfortunately, clear guidelines do not exist for chronic pain. Even the … [Read more...]

What is the relationship between physical activity and low back pain?

The Australian Twin low BACK pain (AUTBACK) study Almost all guidelines for the prevention and management of low back pain (LBP) emphasise the importance of regular physical activity and exercise [1, 2]. Surprisingly, the question of whether physical inactivity in general, or specific forms of physical activity, are risk or protective factors for … [Read more...]

Exercise for chronic whiplash – the road to Nullville.

It seems like only yesterday I was blogging about an important trial of targeted care for acute whiplash, which like other such trials returned a convincingly negative result. It seems that our best efforts at improving outcomes in the early stages after whiplash injury do not achieve their goals. But what about when we intervene with a group of … [Read more...]

Tactile acuity training meets back pain meets Frankie goes to Hollywood

Cormac Ryan

One of the most exciting areas of pain science at the moment is brain training. To me this is the idea that the patient’s brain image of the painful area does not match the physical body itself and this mismatch, for some reason, maintains the pain. Brain training interventions attempt to correct this mismatch by reshaping the brain image to … [Read more...]

Illusory self-identification with an avatar reduces arousal responses to painful stimuli

Daniele_Romano

Pain experience can be modulated at different levels of processing and is influenced by higher cognitive function like attention and expectations. It has been shown recently that looking at one’s own hand, but not at a neutral object or another person’s hand, induces analgesic effects while receiving acute painful stimulation (Longo, et al., … [Read more...]

Can Pain Neuroscience Education Improve Endogenous Pain Inhibition?

Many chronic musculoskeletal pain disorders are characterized by the presence of central sensitization, which implies that the central nervous system is in a hypersensitive state in those who suffer from these disorders. Sensitivity to pain results from the outcome of the battle between pathways which facilitate the passage of nociceptive … [Read more...]