Sleep - pain - sleep - pain - sleep

Today a client and I were discussing sleep. She said to me
‘Why is it that I can’t get off to sleep because I’m so sore, then I have a bad pain day, I’m really tired,
and I still can’t go off to sleep, so the next day I have a worse pain day.’
We’ve known anecdotally [...]

Smoking and pain

Something I’ve noticed many times is the number of people experiencing chronic pain who also smoke. It used to be thought that people who smoke perhaps had poorer health behaviours which lead them to be less fit, less careful about eating well, and perhaps to having poorer responses to stressors generally. And I’ve [...]

Am I right or just dogmatic?

Even in health care, the loudest voice with the largest opinion can be the most persuasive - even with limited (or selective) use of scientific evidence. Sadly, fads exist in pain management too.
To counter our human biases we need to be critical of all research, and ask some serious questions about accepted practice as [...]

Mindfulness effectiveness

One of the most delightful aspects of the ‘new wave’ of cognitive behavioural therapies is the continued adherence to test the effectiveness of therapy in a scientific way. There has been quite a flow of ACT (Acceptance and Commitment Therapy), CCBT (Contextual Cognitive Behavioural Therapy) and allied therapies in the psychological literature, and now [...]

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 [...]

Photographs of activities of daily living - cervical spine

Assessing fear in patients with cervical pain: Development and validation of the Pictorial Fear of Activity Scale-Cervical (PFActS-C).
Turk DC, Robinson JP, Sherman JJ, Burwinkle T, Swanson K.
Ever since the PHODA or photographs of activities of daily living was developed, I’ve used pictures to help establish exactly what movements and contexts people are worried about. [...]

Reduction of pain-related fear in complex regional pain syndrome

As promised, at last a post on graded exposure for pain-related anxiety and avoidance, as applied to complex regional pain syndrome, or CRPS. This paper was published in 2005, and as far as I know, there have not been any replications carried out, so it must be seen as an initial experimental approach that [...]

Colour therapy…

With only a small proportion of the people experiencing acute low back pain becoming chronically disabled by their pain, a holy grail of sorts has been to quickly and effectively identify those who need additional help and those who don’t.
The ‘Psychosocial Yellow Flags’ initially developed in New Zealand by Kendall, Linton & Main (1999) provides [...]

Accepting Low Back Pain: Is It Related to a Good Quality of Life?

Victoria L. Mason, Beth Mathias, and Suzanne M. Skevington
This study examines an area of disability ‘adjustment’ that is becoming increasingly important in to therapists and others interested in what helps someone develop readiness to adopt self management rather than an ongoing search for a ‘cure’.
Acceptance refers to ‘a willingness to have pain without [...]

April already!

It’s April and time for a change of season, sadly.  For us in the southern hemisphere it means we’re moving swiftly into autumn, with the leaves outside my house becoming yellow and fluttering to the ground, and the hint of chill in the air at night and early morning.  After a weekend away, it’s a [...]