Work is the context

For many years I’ve worked in pain management and tried to help people return to work as the completion of their rehabilitation. Why? Well, apart from it being a great thing from an insurer or funder’s point of view, it’s actually what people want.
Having been through my own return to work rehabilitation after my [...]

Context and sociocultural factors

I posted yesterday about how little social and cultural factors seem to be included in assessing and managing pain, and I had hoped to find some papers to discuss today. Events conspired and I have failed in that endeavour, so this post is, unusually for me, almost entirely my opinion.
So, sticking my neck out, [...]

It’s not rocket science - it’s respecting the individual

Using cognitive behavioral therapies in pain management isn’t really rocket science, it’s simply being aware of the principles of learning from both a cognitive (thinking) point of view and a behavioural point of view. It is, however, complex - by that I mean, there are many threads to systematically follow and actively manage.
There does [...]

New blog to watch!

If this post is anything to go by, and from the ones I’ve read, it is, then dipping in and out of Science-based medicine is a very good thing.
The authors are respected scientists and doctors who write eloquently and thoughtfully about issues to do with those gray areas between science and [...]

Effects of disability - diathesis-stress

I’ve posted before on the effects of disability that make coping a challenge - today I want to cover a few more areas. My aim is not to suggest a ‘poor me’ attitude towards people with chronic pain, but instead to highlight how these demands might affect core beliefs. This is an important [...]

Chronic pain is not a mental illness

In New Zealand at least, obtaining training in pain and pain management is fairly restricted. Two papers specifically on pain and pain management for ‘all-comers’ are run through my Department at University of Otago, Christchurch, but apart from this - I’m not sure of any others at postgraduate level. Occupational therapists have the [...]

Faking and malingering (again!)

One of the most popular posts I’ve written on this blog concerns ‘faking’ or ‘malingering’. I’m curious about this, because even though I have been asked many times whether I have had patients that are ‘faking’, I don’t think about it very often myself. I suppose it is a subject that is dear [...]

Fear/anxiety, pain and movement…

The best way to start this week’s series of posts is by quoting Simmonds, Moseley & Vlaeyen (2008) who said: ‘Chronic pain and its often associated movement dysfunction are pervasive, intriguing and complex problems … conceptualisation of pain and movement dysfunction has increased our understanding of both…that conceptualisation remains incomplete until it also includes the [...]

Pain, disability and psychosocial factors

Something that can really get my goat is when people think that because someone has high disability, and they have pain, it must be the pain that ’causes’ the disability - therefore reduce the pain, and you will inevitably reduce the disability.
This can lead to over-treatment of pain with medication (to reduce the pain, often [...]

Centenarians also get back pain…

Pain in the Back and Neck Are With Us Until the End
A Nationwide Interview-Based Survey of Danish 100-Year-Olds
I’ll bet you thought that at some point in life we might not be at risk of back or neck pain - guess what, we’re all wrong. This fascinating study by Jan Hartvigsen and Kaare Christensen looks [...]