If you’ve visited my pages, and feel like hanging around a bit, don’t be shy – introduce yourself! I would love to find out more about who is reading these pages. You don’t need to reveal all – just a little about what you’re fascinated by, where you live, what you’d like to see more of… I promise NO SPAM! just the opportunity to get to know you better.
Any contact you make with me via this site, including personal emails, will never be passed on to any third party, and you will never receive advertising material from me. I do not advertise on this site, and do not receive any revenue from advertisements. You may find advertising material on other site you link to from this site.
See I even brought baking!!
(psst! That’s NOT me!)
Date page modified: 1 March 2008
HealthSkills Blog 
Just realised that you have this page – a good idea. I teach OT in Otago, New Zealand. My particular area of interest is clinical reasoning so I’m interested in the various ethical issues that are raised in practice and how we view these. I teach mainly in the post-grad programme (by distance) but also in the final year of the undergrad programme.
We are currently in the middle of summer over here – for some reason I am assuming that you are in the Northern Hemisphere.
Hi Bronwyn,
I have forgotten the password for the OT section. Woudl liek to ask a question that I am sure you will have a response to!
Linda
Woops – just realised that you are local. Should read your information first!
Hi Linda
Welcome to the baked goods and coffee section of my blog!
Yes, I’m NZer, in Chch, spreading random pieces of (I hope) thought-provoking ‘stuff’ to anyone who’ll read!
Already from what you’ve commented on I think you and I have some similar ideas as to what some of the short-comings are within clinical practice – to me it’s not just clinical reasoning per se, it’s an ongoing need to be scientifically sound, critical of all things so we ensure we do our best for our clients. While at the same time ensuring it is our clients who make the choices. Problem is – we shape the range of choices for our clients quite often, so we have a very powerful role.
Looking forward to much much more debate!!
Linda… you do know Bronwyn – well she teachers our pain management course!!! Tee hee.. its a small world!
Merrolee
Hi there,
I just discovered your blog as I was searching for some that I may want to link to mine. You have some very interesting information.
I’m in Montreal, Canada. I’m a nurse originally, I’ve worked in various areas from medicine to palliative care (talk about dealing with pain there!); I’ve worked clinically and as a supervisor and teacher.
Now, however, I work as a freelance health writer. Although I write for both professionals and the general public, the nurse in me loves the patient education aspect of my work.
Anyway, that’s about it for me. I like your site and I’ll be back.
Thanks!
Welcome to my blog! I’m glad you enjoyed it, and I’ve popped on across to your blog – and you’re added into my blogroll now. Thanks for introducing yourself!
I can’t remember if I have commented on any of your posts before, I’ve been reading for a few weeks to a month or so. I’m Nickie, a social work student at a private college in the upper midwestern part of the United States.
I’m hoping to go into working in the pain management area. I have a lot of experience in that area because I have Complex Regional Pain Syndrome.
Hi Nickie
It’s lovely to hear from you, and thanks for introducing yourself. I hope you find something to interest you on these pages! I have worked with some really interesting social workers, who add something quite unique to pain management.
Hi Adiemus,
I was looking for an email address on your Adiemus blog so that I could invite you to vazaar, but nothing there. Also, I see from your sidebar you are on flickr anyway, so vazaar would be of no use/interest to you I suspect since your ‘downsizing’ of your activities.
Re pain management, sorry to hear about your concussion, but happy to hear of how you are coping. I myself have had spine problems since my mid-teens 100years ago, a form of arthritis. Learned very early on how to manage that, and other health issues as well (I would have made a fantastic doctor the amount of health stuff I know now!). My philosophy of life has been, and still is, to not let these things get in the way, to learn how to manage/deal with the issue, and then just get on with it. Life’s much too short! It’s worked for me, so far.
Hope you’ll visit my blog, Lolly A Personal Sketchbook, again soon. Cheers!
Hi there!
Lovely to see you tracked me down!! Thanks for your interest in my photoblog – i’ll be continuing on it occasionally, but my focus this year is more on this blog, and photography as fun with less posting.
It’s also great to hear your philosphy on coping – it’s got to be so much more than ‘just coping’, much more like ‘let’s live’!! Living with a chronic problem doesn’t mean anything different from just living a good life, I think!
I’ll be popping in to your vazaar site again soon, and will put it on my blogroll too!
Take care
Bronnie
Hi,
Just a brief hello as I find your blogs very interesting and relevant. I am a physiotherapist working within a Pain Management setting as part of an inter-disciplinary team. Still finding my feet, but getting sufficiently interested to see the positives in an area often preceived as unrewarding.
I enjoy the tone – informative, with a chance to review the original research, but with a personal perspective too!
I generally get caught up in the abstract – so if I stray from ‘the point’ feel free to draw me into line. Have never felt strongly enough (or confident enough) to offer an opinion on these forums, so feeling quite liberated!
Thanks
Welcome to the Intro page – and it’s GREAT to see that you feel confident enough to contribute. It’s always nice as a blogger to feel that there ARE people out there that are reading and enjoying what is written to make comment, so go right ahead.
I’m glad you’re enjoying the pain management side of physiotherapy – we really need all disciplines to think ‘what can I offer the team’ rather than ‘what is my role’, so that patients and team members can share in what can be a really challenging area of work. I particularly like physiotherapists to help with engaging people in regular activity because patients often respect physiotherapists encouragement (whip-cracking) where they are wee bit shy of other members of the team saying that exercise/activity is good.
Thank-you for publishing this blog. I am a massage therapist working in the field of pain management. I have a lot of clients that have fibromyalgia, so your information is very helpful! !~!~!
Hi Christine
You’re very welcome, it’s a pleasure to know there are people out there!! And while I don’t promote massage as a self help strategy for pain, I do know many people are ‘touch-starved’ and massage is both a relaxing and a caring way to help people connect with their bodies again.
Thanks for visiting and keep in touch.
Hello, im Sven i am OT from Zagreb, Croatia, working in a post stationary centre with mostly neurological impaired people of any age. As occupational therapy is not on proper level in Croatia and it is unknown not only to people but for doctors and even some psyshiotherapists i have hard time to work in this field. I had basic bobath course and started to learn about feldenkrais method… still i want to do something and bring closely OT to my patients. After all ADL most important in every ones life
Regards
Sven Erić
Hi, Im Howie. I just wanted to say that I have been researching the aspects of Hypnotherapy for a while and I found your posts to be very infomative. My sister is a Master Reiki and also a massage therapist and I am going to send here here to check you out. Thanks!
Howie
http://hypnosishype.blogspot.com/
HI Bronwyn,
Just discovered your blog a few weeks back and have been tuning in most days. You are really making me think about what I do and why, which is awesome for me working essentially on my own. Great links to useful tools and reading matter. A useful back up to your courses. I’m impressed by your dedication!
GREAT to hear from you! Where are you now and what are you up to?
Give me an email (address is on my About page!)
I really like your blog. I read the article on Fibromyalgia for July ’08. The client’s research revealed her Fibromyalgia was related to 3 viruses. Would you share the name of the them? My practice is in Central Florida, Maitland. I have a few Fibro clients and am always interested in providing improved service to help the clients. I’m in the process of having a blog created. Do you have any tips you would like to share?
Hi Mary Anne
I’m sorry, but I completely overlooked your comment until now! I don’t know what happened… Thanks for stopping by and commenting. The fibromyalgia research suggests that there are quite a few triggers that may initiate central sensitisation – among them are the epstein barr virus, herpes simplex and many of the common cold viruses, as well as influenza viruses. FM can also be triggered by physical events such as a strain or sprain, and it seems that stress can also precipitate the syndrome. There are quite a few articles about central sensitisation, I’ll review one or two of them shortly. BTW I love the photographs on your blog – they’re beautiful!
hello,
It looks like you set up quite a network here. We’ve been in the pain relief business for over 30 years. We are completely no medical and have had tremendous success helping people… if they are ready and wiling to change their minds. I’ll be back to visit your site often.
Hi!
Thanks for visiting and introducing yourself. It’s always a pleasure to ‘meet’ someone else who is interested in helping people be active despite their pain. I look forward to you visiting again and hope you’ll enjoy what I blog about!
cheers
Bronnie
Hi,
I’ve veen reading your blog for some months now and thought it was about time I introduced myself. I am an occupational therapist at The Pain Centre, St. Paul’s Hospital, Vancouver, BC, Canada.
It’s wonderfully refreshing to read your blog. I don’t know of any other site that offers such relevant and science based insights into pain management. THANK YOU.
Clare.
PS – Love New Zealand. I used to work at Christchurch Public Hospital many moons ago.
Hi Clare
Thanks for dropping by, it’s a pleasure to see where people come from. We have one of your colleagues working at the Pain Management Centre, Burwood, he’s Canadian/American at least…
You know you can come back to NZ – Chch Public probably hasn’t changed very much!
Do let me know what you’d like to see more of in the blog, it would be great to know what people like and want.
cheers
Bronnie
Hi Bronnie ,
I got to your site via Somasimple which developed from David Butlers NOI site a while back. I work as a Physiotherapist near Stirling Scotland and have been interested in pain science and education for a long time. I was initially influenced by Louis Gifford and the UK Physio Pain group whom I contriubute a lot of articles and weblinks to.
I love all the neuroscience esp the recent brainscience podcast and dericbownds site but still find something missing about the whole enterprise! I have been doing a MA in Medical Humanities and the non tangible but important aspects of people really interest me a great deal. A friend of mine is a Dr and you might like his heroes not zombies blog!
I am doing my project on biocultural aspects of placebo and like you Dan Moremans work is fascinating and should be more widely known. I also love David Morris writing if you haven’t read his stuff its brilliant.
I like taking photos http://www.flickr.com/photos/ianstevens
I believe in neurogenesis and my midlife crisis meant learning the flute (cheaper than a motor bike ). I havent been to NZ but a maverick colleague now is in Christchurch and an old friend is a GP there. I would love to go to the Alps to climb Aspring and maybe go to Nelson as it seem to be full of hippies and artists!
ian
Hi Ian
Great to have contact with you – this network is growing!
You simply have to make to NZ, and especially Christchurch if you like photography, climbing and pain management. Although they don’t seem to go together, in Christchurch they do! We have quite a few people working in pain management, and because we’re close to the mountains we have loads of climbers and photographers too. Check out my flickr stream and take a look at the group NZ Mountains (I think that’s what it’s called!).
keep in touch – oh BTW my midlife I decided to learn guitar, bellydance, go scuba diving, and start my PhD – how bad is that?!!
Hi there, I am currently an occupational therapy technician (in final 6 months of completing my full blown OT degree) and hope I can be included! I am based in the UK and came across your site whilst researching the use of the nintendo Wii in stroke rehab. As our final 10,000 word assignment is a research proposal I thought I would base it around this as my last practise placement was in a stroke rehab unit and I got a company to donate one! I have toyed with working in New Zealand as apparently they will take “mature” OT’s (I am a young 48) but feel I should try and least have a holiday there first.
Keep up the good work! x
Hi Karen
Thanks for introducing yourself – I’m not quite as ‘mature’ as you, but catching up fast (the naughty 40’s huh?!).
Yes, we like people who have seen the world a bit, in NZ, because you add so much to our country. Welcome to the blog – and I hope you stick around!
I’ve just used the Wii for the first time with our pain management programme – they complain that it ‘made’ them do ‘too much’ – but they were having so much fun at the time!!!
Wow…Very nice post and I would like to learn more
Hi there, a very interesting and informative. I developed rheumatoid arthritis 4 years ago, and have manged to restore my body to its original state of health. A change in diet, extensive work on emotional issues and natural supplements was the recipe that worked for me.
Hi Claudia
Thanks for taking the time to comment -and welcome to blogging!
I think there are many things an overall healthy lifestyle can help with. While I don’t think there is a lot of evidence that your diet on its own changes the rheumatoid condition, there are a lot of people who say that by eating well they feel better, and as a result they manage their rheumatoid arthritis more easily.
Glad to have you join me from time to time!
cheers
Hi Bronwyn, I have totally duffed my ability to get into the OT bit of your blog – I have forgotten my password. Can you sort this for me – please! Am trying to sort out OT problem solving at the moment. Well get in vlear in my head at least.
Hi Linda
I’ve send you an email 🙂
Hi
Our Tutor Clare has suggested to us your blog as a good read on Research. I would like to thank you for your insight. This being the beginning of our class and only us really starting to understand the hugeness of this topic its nice to read other thoughts that help with the understanding.
Thanks
Tiffany
Hi there!
Welcome to my blog, I do hope you enjoy the posts – and have a giggle at some of my silly things too. Please feel free to comment and debate and question – that’s what the web is all about!
cheers
Bronnie
Hello,
Our company has similar interests in medical education. We are just getting started and find the web a great medium for education and encouraging health.
Tom
Hi
I just stumbled into this blog as i was researching for my assignment. I am a registered mental health nurse based in Birmingham England. I am currently studying for my degree in Cognitive Behaviour Therapy ( it’s not as posh as it sounds) I’ll be wrking mainly with people experiencing anxiety disorders or depression.CT teaches clients that there is always more than one way of seeing events and, therefore their viewpoint is largely a matter of choice. Well something like that. . I shall surely keep in touch!!!
Hi Isabella, and wecome to the blog! I’d love to do a degree like yours – I think CBT is a very helpful approach for people whether they have an ‘illness’ or not! (actually I’d like to see schoolkids taught this in health classes to help them develop resilience). I post primarily about chronic pain management, but as you’ll see there is plenty of cross-over into other health problems. Let me know if there is anything specific you’d like to see on here, and I’ll do my best!
cheers
Bronnie
Apparently lots of people benefit from CBT as evidence when it was run as a ‘night class’ / lecture format. Apparently there were large crowds of people who attended regularly and said they benefiited from the experience. This was in Scotland. The charisma of the person running the sessions was no doubt a major factor, but whe asked people thought he was empathic as he demonstrated that he understood the way that they were thinking. Perhaps as effective as smaller groupsor one to one. Who knows, but interesting.
Hi Linda
Good point – I think CBT is a set of skills that in the end help the person become his or her ‘own therapist’. It shouldn’t just be effective because of the charisma of the person, and in the case of CBT it is apparent that the evidence supports the processes and not just the personality! I wonder if this is something public health people could do more with – given people’s curiosity about ‘psychology’ and need to develop resilience, maybe community-based CBT courses should form part of a public health approach to wellbeing!
I have been a social worker for about 25 years. At present, I work in a hospice in Philadelphia, PA in the US. Our mission is particularly to bring care to those who are homeless or living in shelters. I also have been diagnosed and live with chronic pain and fibromyalgia. So I am fascinated to learn whatever I can about pain management. I especially appreciate the mini lectures you offer on the neurology of pain.
I am convinced that professional trust and easy going communications lead to the better pain management teams. Needless to say, teams need to include social workers.
Hi Esther
Thanks for introducing yourself, I’ve appreciated your comments on recent posts. I agree that we need to have a broad interdisciplinary team when we’re working in pain management, and the social workers with whom I work have been both a varied bunch, and people who deeply care. I like the systems view that social workers bring to our work. I hope to hear more from you in time!
cheers
Bronnie
Hi,
I have taught mind-body and hypnotic pain relief techniques to hundreds of frontline physicians, nursing professionals, physician assistants, dentists, psychologists, and podiatrists who treat patients in pain at PAINWeek, a major medical conference (PAINWeek-Conference Faculty http://painweek.org/About/Faculty.aspx) and I will be teaching an expanded program at PAINWeek 2010 due to the feedback they have received from the practitioners who have attended my PAINWeek seminars in September 2009.
I was a an active member of a NIH Community Research Initiative exploring Alternative Medicine from 1988 to 1992 and my Complementary and Alternative Medicine Blog appears on the multi-award winning website http://www.therapytimes.com I have been awarded top honors from every professional hypnosis organization that I belong to including the International Medical and Dental Hypnotherapy Association, the National Guild of Hypnotists, the International Hypnosis Federation, the International Association of Counselors and Therapists and the National Federation of NLP. Here’s what the American Academy of Pain Management said about the guided self-help program that I developed for people with IBS. “Quantum Focusing®, self-directed program of self-hypnosis exercises, alleviates IBS symptoms safely & affordably without drugs or surgery”
http://www.aapainmanage.org/currents/curindustry0407.htm
Consider me a resource.
Michael
PS – OTs will find that http://www.therapytimes.com is an practical resource
Hey there Michael
Sorry for the delay in getting your comment up on here – somehow it slipped through into spam and I didn’t see it! My humble apologies.
I think hypnosis is a really helpful strategy for some people and I use it myself, so yes, would love to see you drop by every now and then. I’ll put a link up to the therapytimes blog.
Hi,
I completed one of your CBT courses a few years ago now, when I was almost a new graduate OT, and found it very useful – althougth now that I have a lot more practical experience in the field of pain management and voc rehab I’m sure I would identify with the content and examples a lot more, and I am keen to refresh on CBT and the wider skills of self-management etc. Was hunting the web to see if you had any future courses coming up when I came across this blog – is awesome, has definitely got me thinking. After coming back to work recently from maternity leave it has made me remember how much I enjoy new learning, and your site is a great way to get that spark going again – am even considering some post-grad study!
Keep up the great work and let me know about any courses you are running – I am working fairly independenly now, so soaking up info from every angle is going to be a top priority for me – researched and robust info of course!
Raewyn
Hello, wow I’m not only impressed by your blog, I’m impressed by your readers as well! I am a back pain fighter who’s winning for a lot of reasons but the most recent being my study of Dr. John Sarno’s mind-body connection theories and an incredible book I just read called Overdosed America, by Dr. John Abramson. I’m more and more convinced that people with back pain are really tragically led down the wrong path by the health care establishment in the U.S. It’s tragic because I believe the majority of those suffering what I have (2 surgeries, no fusion, bouts of chronic pain over 20 years) can fix themselves if they only are given the tools.
Hi Chris
Welcome to the blog! I’m glad you found your way here. I’m not a supporter of Sarno, there isn’t enough peer-reviewed evidence for me to feel comfortable with his theories or approach – but I am happy to say that there are plenty of other approaches that incorporate the idea that the mind and body are connected and that we can manage our pain well by living well, and thinking differently.
Let me know if there is anything you’d like me to find out, or write about, and I’ll see what I can do.
cheers
Bronnie
Bronnie, thanks for your warm, honest welcome. I have heard similar criticism of Sarno. I suspect there are flaws in his research but I also think he’s up against a large back pain industry represented by groups like the Advanced Medical Technology Association that discourage the expensive, prospective, randomized, double-blind, placebo-controlled studies that would provide a definitive judgment on his work. As medical research has increasingly been funded and conducted by the drug and medical device industries (leading to regular non-publication of study results and epidemic conflicts of interest in the most respected medical literature) I am finding it extremely difficult to retain any confidence in the U.S. medical system. Like the financial industry, I fear the poorly regulated free market and our flawed, insurance-funded pay-for-procedure approach is actually making many of us sicker. That said, I would love referrals on mind-body approaches to chronic pain – I’m currently reading Herbert Benson. Thank you again for your excellent blog.
Chris
Chris, a great read if you’re keen to see how the medical system in the US (and I’m afraid much of the world) has warped our sense of what is illhealth and what is not, is the latest book by Norton Hadler – Stabbed in the Back. It’s a fantastic expose of the ways in which medical-only views of health and especially back pain have unnecessarily alarmed people and encouraged medicalisation of what is often simply normal experience.
The way I’m moving with living ‘with’ pain is to use mindfulness and ACT, along with generally living well, as the way to have a life while accepting that pain will be there for some of the time. So will fatigue and so will nausea and other bodily experiences. I can remind myself that I’m in the driver’s seat, not my internal states! More on this soon.
I’m glad you feel comfortable here, it’s great to see the range of people who find themselves dropping by!
cheers
Bronnie
Excellent, that book looks like a great resource – thank you once again. ACT looks worthwhile, at least after a cursory glance on the Web. It’s funny how so many healing journeys lead down familiar paths. With Sarno, with ACT and other stops along my path (Tai Chi, Feldenkrais, Rolfing), I get feelings of deja vu that reassuringly reinforce my improving sense of direction. Take care!
Ok,
About time I got on here, I’ve decided to use this site to keep me in the loop while my brain goes on holiday in nappy land….
Interestingly I am experiencing back strain at the moment and am pleased to say that while quite intense, the cognitions that I teach (don’t panic, pace, breathers and sensible meds) is working well for me!
Will continue to be a visitor, thanks for reminding me to look on facebook.
JO
NAPPY BRAIN!!! I remember it! Now I have teenager tantrums to deal with, it’s actually no better!!!
It’s great to have you on here Jo, and I’m looking forward to you being part of my rants (only on the odd occasion, of course!).
cheers
Bronnie
What a great find this site is! Sue from Trumbull, CT here, and I was sitting (should be doing those exercises, sigh) and googling about OT stuff, back to work rehab information, etc. and came across your place. I’m a special education teacher, and your place has given me so much feedback on so many levels. Thank you.
I hope you don’t mind – I’ve cut and pasted your posts on Pacing, Relaxation training, meaning focused coping. I’ve had a 3 level spinal fusion Oct. 9th, and spent over a month not knowing that the pills I was taking were giving me opioid induced hyperalgesia – what a disaster. My saving grace was finding Carolyn Myss’s book “Why People Don’t Heal” – and realizing that pain not something to fight against and fear, but it’s a journey of growth.
Hi there Sue
Welcome to the blog! I’m so glad you introduced yourself, and found some things you were looking for! Help yourself to the material on here, especially if they help you! If there is anything you’d like me to post about, drop me a line and I’ll do what I can to help.
Cheers
Bronnie
The U.S. has a new intervention system (RTI) that demands a lot of data before students are evaluated for special education. Teachers must provide documentation and accommodations before the students finally need Special Education evaluation.
It’s a tough one to get teachers to accept it, but now it’s a federal mandate. It’s also funny to observe how the health professions don’t follow basic data documentation.
This is a cut and paste from an email I sent to some colleagues today:
Hey guys!
Going back after surgery to land therapy, I was wondering what kind of evaluation I would get to give me base-line data, and what kind of expectations I would have to meet.
What does the state require for reasonable back to work expectations? How about my doctor, so he could write that note? What will my goals be? How do I cope with a back spasm – will there be a flare-up management plan? How will I know I’ll be successful? I really want to get back to see you guys – I know it’s been awhile.
Well, on Wednesday, with my return to land physical therapy, a young woman brought me into a room and had me bend forward and backward. She took notes. It took 5 minutes.
She sent me home with some easy-do exercises, like squinch my back down 10 times onto the floor.
I’m like, is that it? That was my evaluation?
You know me, I was up until 12:00 last night researching physical therapy requirements, goals, objectives, pacing guides, PT sample evals, plans of treatment, etc. I’m finding stuff like this:
http://www.occupationalinfo.org/09/094227030.html
Today I had my second visit. I asked (nicely) if I could discuss these issues and develop a Plan with current functional abilities, goals, evaluation dates, interventions, etc.
Eyes rolled. Sighs were heard from every PT in the room.
A senior therapist came over, and had me do some squats. We talked about how we really could never document what would happen, because I’m different from everybody else.
These are my goals.I am not making this up:
– PT will stand x=40 mm. Erth 2/10 LBP
– PT will squat c (with a little line over the c) 1VE assist…something (with that c again) 2/10 LBP.
– PT will bend to flow with proper telephone (?) with 2/10 LBP.
And I am not supposed to ask anything else, because they know best, and that’s it.
From my one experience with this one business, it is the equivalent as having a special education student without an IEP, PPT or academic goals. That is one big time lawsuit waiting to happen.
In conclusion, I’m switching to another group. Their assessment takes at least an hour, so maybe there’s hope they will have a data collection system that they will share with their clients.
Hi,
I’m Jeris. I’m an OT student in MN. Feel free to check out my blog to learn more about me…I have posted some links to your information, if that is ok. I think you have a lot of great information that helps fill in the gaps of information that wasn’t offered in school. I also like some of the issues you raise on your “just for OT’s” section.
I look forward to following this site! Thanks for the work and thought you’ve put into this!
Hi Jeris!
Thanks so much for connecting and linking, it’s a real pleasure to ‘meet’ like this, and to hear that you like the blog. I’ll email you with the password to the occupational therapy only section, and look forward to hearing what you have to say (and reading your blog too!).
cheers
Bronnie
Hello, I’m Neil.
I’m not an OT or even a health care worker of any kind. I do, however, write the ThinkingOT.wordpress.com blog for a UK OT training company. I shamelessly exploit my naive perspective on the OT sector.
Think of me, if you like, as the wide eyed child, in wonder at the vast range of work, philosophies and values to be found within OT work.
My guess is that this must be one of the most detailed and frequently updated OT blogs out there.
I’m glad I found you. I am likely to refer here frequently, and if an outsiders viewpoint is welcome, well, I’m happy to oblige!
Kind regards from Bath, UK!
Hi Neil, I’m so glad you found the blog and enjoy it! It’s grown its own life almost, and I get to make contact with people from all over the place – including Bath! One day I will manage to visit Bath, I really want to meet the researchers on pain at Bath University (and maybe meet you!). Thanks for taking the time to comment and introduce yourself, it’s always a pleasure to get to know people!
cheers
Bronnie
I appreciate this site given 1. I am a licensed psychologist who wishes to work more with patients with chronic pain 2. I have had two neurosurgical procedures, one being a cervical lamoinectomy and the other an L4 Hemilaminotomy, the latter proving unsiccsessful. I do have degenerative stenosis and am doing intensive physical therapy to help deal with ongoing muscular spasmodic pain. So, I can attest to the relevance of this site to both my own capacity to cope and to provide support to others via CBT and resilience strategies.
Hi Dr Beilin
Thank you so much for taking the time to introduce yourself – it’s always a pleasure to find out who my readership is, and to know more about their interest in chronic pain management. I’m sorry to hear of your own pain problems, pain doesn’t pick and choose who to affect does it?!
From my own experience I think having persistent pain as an individual can be useful if you’re also a therapist working with people who also have chronic pain – at the very least, no-one can say ‘but you wouldn’t know what it’s like’! While I’ll never know what it’s like for that person, I do know what it’s like for me, which gives me some empathy. It also gives me a good deal of motivation to give patients I see a better deal than they may have had in the past.
I hope you drop the occasional comment in on posts that you like (or dislike!) and let me know if there is anything you’d like me to discuss on here too.
cheers
Bronnie
Bonnie-
My perspective for patients and even those professionals like myself who experience ongoing pain and work with pain patients is to reframe ones condition as following a ‘pain management lifestyle’. To get there implies mourning how one used to be versus the way one is rather than continue in the cycle of pain-depression -anger-pain….) Getting there involves assimilation of information about ones condition, then accomodatiing and adapting. This is it. . Choosing a Pain management lifestyle is now ones ongoing ‘challenge’. From here hopefully comes resilience via a variety of modalities .I believe interpersonal connectedness to others such as writing in this blog is most critical. One technique is not the most suitable for everyone.. Presently, I am wearing a TENS device to offset the risk of needing to have a spinal fusion- something that concerns me given the extent of negative consequences from those I’ve known who have had the surgical procedure. While I experience something akin to 300 pounds of weight on my lower L and upper S area (a ‘pain in th a..,) emnanating from degenerative stenosis in that area, II take long walks, swim, do an eliptical machine and use some machines to strengthen my core. Cognitive techniques including the reciting of adaptive coping statements is most critical. What further concerns me in the pain management field is the reality that there are those individuals who truly need opioid derivative medications on an ongoing basis and who don’t abuse them. Physicians are frightened to prescribe them even at pain clinics where the focus often is temporary cortisone injections or radio frrequency nerve burning. I’d like to hear from others as to what they hasve found heklpful in choosing a ‘pain management lifestyle.’
Hi George
I agree that many clinicians are fearful of prescribing opioids, fearing that people will be ‘addicted’ – but addiction and physical dependence with the need for increasing doses to reach the same effect are not the same thing. According to the American Society of Addiction Medicine, “Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in the individual pursuing reward and/or relief by substance use and other behaviors. Addiction is characterized by impairment in behavioral control, craving, inability to consistently abstain, and diminished recognition of significant problems with one’s behaviors and interpersonal relationships. Like other chronic diseases, addiction involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.” Dependence is what anyone using an opioid will experience – the body needs more of the substance to achieve the same result. People who are prescribed opioids for pain, and who find themselves needing increasing amounts are simply responding as anyone would, addiction is usually/often demonstrated in other spheres of behaviour apart from opioids.
However – I don’t personally support the use of opioids in younger people. This is simply because of the dependence problem, because as the dose increases so do the side effects – and the side effects of opioids include respiratory depression, constipation etc. Not quite what you want to live a good life.
So I think it is preferable to develop a broader range of coping strategies, minimise the use of opioids, use alternative medications if necessary, and as you say, mourn the loss of what you can no longer have but then add in what is good and rich and fulfilling.
Thanks for introducing yourself – it’s always a pleasure to ‘meet’ new people via the blog!
Thanks Bonnie. One can choose a ‘pain management lifrestyle PML’ that consists of a variety of modalities. I believe intepersonal connectednesss such as being on this blog is critical. The alternative is being in a cycle of pain-depression-anger-stress-pain-depression…) To get to PML one has to mourn the way one was versus the way one is.
Presently, I use a TENS device to ward off the need for a spinal fusion- something I’ve only heard negative consequences including greater pain and lessened flexibility. What concerns me in the pain clinic philosophies is to overfocus on temporary relief from cortisone injections and radio frwequency nerve burning. I truly believe many individuals need opioid derivative medications so long as tghey are responsible and sign contracts but Physicians are frightened to prescribe them.
Hello
while teaching a pain management course this past weekend in Vancouver one of the OTs (I am a PT) told me about your blog. She let me know that the two of us are speaking pretty much the same language.
From a quick read of your blog, I can see that is so.
It’s nice to make your e-acquaintance!
No doubt you are busy, but have a look at http://www.lifeisnow.ca when you have a chance. Of particular interest may be the three educational webcasts people can access there about pain neurophysiology and pain management.
Oh, one more thing – exceptional new book out called “Inside Chronic Pain” by Lous Heshusius. Cornell Press. It’s a patient narrative, extremely helpful for professionals to read in order to start to really understand the experiences of people pain in pain. Lous was a university prof working in the area of theoretical constructs and paradigmatic thinking prior to a nasty car crash.
I look forward to following your blog, and will link from my site to yours
warm regards
neil
Kia ora and welcome to the Healthskills blog! I’ll forgive you for being a physiotherapist, some of my best friends are PT’s – and I’m even good friends with psychologists and nurses!
I’m looking forward to visiting your site too – I’ll add it to the blogroll here as another resource for people working in the area. It would be great to catch up via maybe Skype or something sometime to swap notes on what we do.
I’ll look out for the book by Lous as well, I want to look at patient experiences both for my own learning, but also for my PhD.
Thanks for getting in touch!
cheers
Bronnie
I loved your post about mindfulness! I am a Feldenkrais Practitioner and we do all of this with small movements. No judgement, observation…I still have my own difficulties with it…when I am working with another person it is also important to observe myself while I observe them. Very powerful.
Thank you!
Mary
Hi Mary
Thanks for taking the time to comment! I love that feeling of being ‘with’ and simply observing without judging, it’s a fabulous feeling of flow (although not always a positive emotional one!). I think it’s that openness to be with that is the key to being mindful and I hope I can learn to do that more.
cheers
Bronnie
Hi Bronwyn
I’ve come across your blog completely by chance, while looking for some info about chronic pain. I am not sure whether you remember me, but our paths crossed when I was doing 2nd year of training in clinical psychology and did my two months at Burwood. You just completed your thesis at the time. You were so passionate and knowlagable back then, and I can see that this has not changed a jot. Thank you for such an informative and user-friendly blog! Will visit it now on the regular basis.
Warm regards. Irena
Hi Irena
How lovely to hear from you, I do remember you from those years ago! Thank you so much for taking the time to make yourself known. Yes the bug of pain management has never quite left me, and now it’s transferred into this labour of love! If there is anything you’d like to see discussed, let me know, I’ll be happy to find out what I can and try to ‘translate’ into reader-friendly language.
cheers
Bronnie
Great blog! I’ve found some of your blog posts very very informative. Especially the posts on when to adopt new therapies.
I’ve been involved with the development of Mavenlive a physiotherapy software which offers decision support for therapists. Our online application suggests only appropriate treatments based on the therapists entered patient’s assessment.
We have been trying to solve the problem of how to make new therapies readily available once they have enough evidence to be proven effective. There are stats that suggest that it takes 17 years for a new piece of knowledge to become accepted once it has been discovered in research. This is far too long, and at Mavenlive we are trying to tackle that problem by offering decision support coupled with our point and click assessments.
Keep up the great work on your blog!
-Chris
Hello.
I found your website googling chronic pain management, clinical treatment, etc. (can’t honestly remember the exact search parameters I used now). I was fascinated because I rarely get to hear/see what the practitioner is thinking or applying, and am a rather circumspect interstitial cystitis patient who has an understanding of CBT, operant and classical conditioning (step-mother was getting her master’s degree in psychology while I was in high school, for starters, and some counseling later in life during major life changes).
I was awarded disability for my interstitial cystitis, though I did not use the pain from it in my application. I struggle with the regular use of pain medication for this illness, even though my pain management goal has only been to take the edge off enough to avoid the autonomic response to it – changing color, profuse sweating, etc. I keep wondering if there is a way that I can “live with it” and reduce my body’s reaction to pain – beyond visualization, stress reduction and pacing so I can be normal within this.
I will keep reading, and keep learning. I thoroughly enjoy your presentation.
Hi Lisa
Thank you so much for taking the time to introduce yourself – and I do hope my blog is helpful. There are quite a few people with pain who read the blog, and every now and then they’ll chip in with comments – so do please feel free to provide your response to things I post, it’s great to hear back from people! If there is anything you’d like to me post about specifically, do drop me a line and I’ll do my best.
cheers
Bronnie
Great site Bronnie! But watch out for that Pearson guy! ; ) …he and I are friends from the Yoga therapy/PT clan…small but growing. And I introduce myself as a “recovering PT” so be gentle, OK?
love to hear more about your dissertation…did mine as a collaborative inquiry school for people with chronic back pain. Used some QOL scales pre-post, plus thematic analysis of pre-post narratives around their experience of CBP.
Keep up the important work and if you need a cheer leader to get across that dissertation finish line happy to do so from the US desert southwest.
matt
Spoooky – more PT’s and other such warped beasties on here than I ever imagined! And I thought I’d be writing mainly to myself… Thanks for introducing yourself, I’m looking forward to seeing what you think of some of my ramblings – it’s good to swap notes and to stimulated debate. Something that can’t withstand intelligent criticism is probably not worth holding on to, is my motto!
cheers
Bronnie
Bronwyn, I know this is mediated, so not sure if I can answer and put in my own two cents from a patient perspective about Dr. Beilin’s comments. Some of his comments echo my own thoughts, and I’ve wondered if there are appropriate times and people for pain management as part of their therapy.
I have interstitial cystitis. I coped with the pain of it, using OTC meds to be able to sleep, for a long time. I didn’t request pain medication until I had repeated issues with sweating, changing color, etc. One of the reasons I didn’t pursue pain medication is the widespread belief that anyone who shows up at an ER is “only drug shopping” if they say they are in pain, and historical reluctance on my part to demonstrate pain behaviors (which has caused delayed diagnoses in TWO different bone fractures – original examining doctors didn’t think I demonstrated enough pain to have more than a bad bruise at best). To me, it is shameful to wince, cry, hold on to a hurting body part, etc. I kept waiting until the pain levels were so high that I had no choice but to roll on the floor screaming, or at least I was trying to wait for that time. A neighbor told me that the repeated sick episodes from the part of my pain reaction I couldn’t control were upsetting my family, and I should be responsible enough to ask for pain medication.
We still haven’t found an IC treatment that is healing my bladder, and I’m still using pain medication. I am VERY careful with it, in part because I want to cause neither myself, nor the doctor kind enough to prescribe it, any trouble. What I keep wondering, though, is if there is a way that, if I tried harder, or learned a different technique, that I could turn off my body’s autonomic response to the pain? I am very good at managing anxiety, focusing on the positive (another IC patient said she was beginning to believe I was either not sick or a Stepford wife at one point), and still working on pacing (I struggle with wanting to do everything I used to do yet, and have NEVER been good at the two-letter n word).
You can respond to this in private if you would wish and not let it post, or maybe start another discussion thread or write an article about the topic of exactly HOW MUCH a pain patient should be able to manage without opiod intervention. In earlier painful things in my life, I learned that if I used visualization and “turned off” the pain switches in my mind I could cope with most chronic pain (have dealt with spinal stenosis since mid 30s with no pain medication). I even can turn off migraine, though I’ve never found the “switch” for the halos or nausea.
I’m just curious, because most of your articles seem to stress medication elimination and management skills, and though I have no idea where my pain level falls among other people’s pain, I know that I can’t remember another pain (including transitional labor, but I’m sure there are all kinds of other hormones involved when that is happening, anyhow) that made me “sick” the way this does.
Also – if the patient is disabled by other parts of the illness aside from pain (i.e., in the case of interstitial cystitis, frequency of three to four times an hour, physical illness from symptoms flare during travel, etc.) is the goal of treatment still to get them back to work, or is it to teach them to enjoy a life that must be mostly spent at home or in close proximity to it? I am at options of foley cath or wear Depends and wet yourself along the way – and I have Foley cathed occasionally – it isn’t a good long-term solution for many reasons, and makes my disease worse for at least a week afterwards.
I’ll look forward to seeing a post about this. (Not necessarily about my own problems, but about how one sets goals for treatment for a patient, and if there are patients who will have no choice but to at least have some kind of pain medication as part of their therapy). Thank you! 🙂
Hi Lisa, I’ve replied to your personally, but I’d like to post your comments too, because you raise such very important issues – I promise I will respond in a blog post soon.
cheers
Bronnie
Hi,
Thanks for your great blog. For the moment one of my favourites 🙂
I am a norwegian mphysio working in Oslo. I work in a private clinic with all kinds of patients suffering from musculoskeletal ailments. At the moment I am doing CBT education as well, and your blog is a great motivator for becoming a better clinician in the chronic pain management field.
I have translated some of your great sentences to norwegian and put them on my blog together with links to your posts. I hope this is ok 🙂
Thanks again for sharing your work and thoughts. Greetings from a reader up north.
Hi Vegard, thank you so much! Of course you can use the material on my blog – the thought of it being translated is awesome. Good luck with learning about CBT, I am sure you’ll find it useful in your clinic – do let me know if there are any topics you’d like covered, I’m always happy to write about pain management!
cheers
Bronnie
Hi,
I’ve been enjoying your blog for a while now and wanted to send you a compliment on the variety and relevance of your topics. I work in two small pain clinics in rural areas in Alberta and facilitate chronic pain education sessions. I try to stay current on things but it helps to read your posts. Your discussion and links on the mirror box were great! They came at just the right time and I put it to use with an interesting client with CRPS. I’m also using medical acupuncture along with OT. Since I’m very much into self management approaches, I worried that I would set up dependent relationships by offering acupuncture. Its been working out better than I had hoped. Clients understand the need for both short term and long term strategies.
Keep up the great work!
Hi Bonnie
Thanks so much for introducing yourself! Let me know if there is any topic you’d like me to cover, I’m happy to cover things that are raising questions for you because they’re bound to raise questions for other people too!
I look forward to receiving updates.
Cheers
Michele
Hi,
Really helpful blog. I am a second year undergrad OT student in London and am currently on my 2nd placement. Sometimes finding it difficult to put my theory into practice, especially in terms of clinical reasoning. I found your blog about clinical reasoning so refreshing, as I was feeling like I was at a stalemate. It was was helpful to read a different point of view and an honest one at that!
Thanks again,
Dee
Hi Dee
And thank you! I’m glad you’re finding it helpful – if there is anything I can add to the blog that would help you, let me know and I’ll see what I can do!
cheers
Bronnie
Hi !
I am a massage therapist hailing from Laval, Québec. I am currently exploring the works of Drs. Melzack, Wall and Ramachandran. In private practice for 4 years, I’ve had my hands on enough bodies to know that almost everyone hurts, irrespective of their age, occupation and social status. But why oh why? So for the past couple of months I have been weaning myself from the bio-mechanical mindset as to why and how pain manifests and have embraced the biopsychosocial model. No brain, no pain so to speak. I am not the kind of MT who tries to fix uneven leg lengths or Frozen shoulders nor have I ever been. What I do is basically put people to sleep, providing, however fleetingly ,some kind of solace in their crazy, hectic lives. Still, I want to know that what I am doing to my clients won’t cause any harm.
Two years ago, my daughter was diagnosed with Sensory Processing disorder . The OT , spent a lot of time explaining the condition and I remember thinking:
Man, I’ll bet a lot of us , even with our so-called normal NS, experience to some degree, the same kind of suffering and discomfort my daughter goes through on a daily basis.
Reading about neuroplasticity, the neuromatrix and understanding the nervous system a little more each day makes me a better bodyworker. If only because it keeps me humble and more science-based in my approach.
Blogs like this one, help me in communicating more efficiently with my clients. Because ultimately, I’ve come to understand; relief lies in their own hands…
Hi Carol
That’s such wonderful news! I’m so glad you’ve been learning about the neuromatrix and the nervous system, don’t we have fantastic bodies?! I’m hoping you’ve had some contact with the Facebook group Neuroscience and Pain Science for Manual Physical Therapists if not, it’s definitely The place to go for news and discussion on pain science for people like you.
I’m also really glad you’ve let me know that you enjoy the blog I have so much fun writing. It’s contacts like yours that really make this work a pleasure. I look forward to hearing more from you as I carry on writing next year.
Thanks so much for getting in touch,
cheers
Bronnie
Hi Bronnie,
I’ve been reading your blogs for the last few months and we’ve had a bit of chatter on twitter (@ActivePhysioAlb)….finally have some time over this summer break to sit down and comment and say gudday! So keep up the great work, always a good read. My interest in chronic pain was re-ignited last year after doing a post grad pain paper through AUT, so it’s always good to read more, cheers
Hi there Andy! Nice to see you here – and thanks for introducing yourself. I’ll definitely take a look at your blog (they’re sprouting everywhere!) and will put up a link to it. Just sent you a DM via Twitter…
BTW I also blog on activealbany.posterous.com, mainly patient- orientated info re musculoskeletal health, you may have clients that might find something interesting/informative on it.
Thanks again
Hi,
I’ve been following your blog for a while and have been wanting to introduce myself. I feel we are kindred spirits of sorts. I have an undergraduate degree in OT and a MBA, and have for the majority of my career worked in clinical management positions. The past 4+ years I’ve been working for Paradigm which devotes itself to managing catastrophic injury and pain conditions for the workers compensation market in the U.S. (see our website for what we do – http://www.paradigmcorp.com). Paradigm is based in northern California but I’m a telecommuter and get to live/work in western Montana. Me and my other clinical colleagues who manage our pain management clinical and case management services have found your blogs extremely helpful. We are grappling with similiar questions and challenges that you have in your practice. I hope we can open a dialogue and share ideas.
Happy New Year!
Laurie
P.S. I was in your magnificent country and city a year ago. My husband and I went on a 2 week bicycle trip from Christchurch to Queenstown. We fell in love with the place. I hope Christchurch is recovering from the earthquake earlier this year.
Hi Laurie
Thanks for making contact on here – it’s always great to know people are finding what I’m passionate about helpful! I’d love to dialogue and hope we can do so via here or email – I’ll be in touch.
take care
Bronnie
Hi
Thank you so much for this website. I linked here from Diane Jacobs site, which I was directed to initially from Soma Simple. It is so wonderful to have access to people who are reading the journals, obtaining PhDs and blogging this information to people like me.
I’m an Osteopath on the Gold Coast, Queensland and often feel isolated but the internet is a wonderful thing. I’ve been a clinician for seven years and am currently trying to turn all the theory about educating patients into a tangible part of my practice. Your site will hopefully help to make that possible.
Thanks again,
Angie Bruce
Thank you Angie! I’m glad you’ve found it helpful. You might not be aware but there are quite a few osteopaths who have completed the Postgraduate papers I teach through University of Otago (distance taught), so you’re not alone in the osteopathic environment! Let me know if there is anything you’d like me to discuss on here – it’s what this is all about!
cheers
Bronnie
Hi Bronnie. I searched the University of Otago’s website to determine what distance education qualifications would be appropriate and wondered if it was the Postgraduate Certificate in Health Sciences (PGCertHealSc) endorsed in Pain and Pain Management? Would this give me the introductory knowledge of the use of CBT for pain management or is there a more relevant course for musckuloskeletal therapists to complete?
Cheers,
Angie
I just discovered your blog via Twitter and read your blog “A comprehensive pain assessment”. Excellent! Looking forward to more.
I am physician in Palo Alto, California and have practiced chronic pain management for the last 14 years (!) Recently I’ve been working on morphing my solo practice into an “‘integrative medicine” collaborative. Much work yet to be done. Too bad you’re so far away 🙂
My website (still under development, as is my practice) is: http://www.rainbowmed.org.
Hi Dr Perry!
Thanks for introducing yourself and for your kind words. You might have guessed that this is a bit of a passion, and it’s great to see other people around the world with the same kind of feeling for this work. You’re so correct, we have much work to do to learn how to work well together, but it’s SO rewarding for both clinicians and patients. I look forward to your comments. If there’s anything you’d like me to write about, do let me know and I’ll do my best to find it out.
cheers
Bronnie
Hi!
I am Sabrina, from Córdoba, Argentina. I have just discovered your website while I was looking for something about self-regulation and executive functions. It is not clear enough de differences between two terms, don’t you think? Perhaps you can help me!
I am a Psychology and I am currently working with chronic pain patients, especially, with chronic headaches. I think there is so much information these patientes don’t know and is our responsibility let them know it! Is wonderful what you are doing!
Thanks so much!
Sabrina
Thank you for your very kind comments. I agree – self regulation to me at least is about the greater processes involved in how humans set and achieve what is important each day. Executive functioning I think is more about the neurobiological underpinning of this process. But I have to say I’m not totally comfortable with either of my to ‘definitions’! Food for thought.
Hi…I am an osteopath and very interested in the mechanisms of pain…this site is a real find…thanks
Thanks Jody, it’s a pleasure to know that you’re enjoying my raving. Let me know if there is anything you’d like me to write about – and thanks for the encouragement!
cheers
Bronnie
Hello,
I have been on the web for days searching for some direction in dealing with patients who have chronic pain. I work locum tenens and am shocked at the differences in the way that pain is managed in different clinics. I feel completely unprepared to deal with patients with “chronic back pain” that have negative imaging, negative physical exams and are on 150 Percocet a month, Ambien, Soma etc. No physical therapy, no CBT, or anything other than ever increasing doses of opioids. I am beginning to dread going in to work to be faced with endless “med refill” visits for patients who have NO interest in any therapy other than opioids. I am hoping to learn some coping skills of my own
Thanks for being here
It’s a pleasure to be able to help. Maybe those patients who seem to have no interest in anything other than opioids have been trained by their exposure to being offered only those drugs? While I know there are many people who do have opioid addiction, and opioids are not the best drug for chronic pain because of dependency, opioid-induced hyperalgesia, and tolerance over time, it’s often used by doctors who themselves have no idea about what to do for people who are distressed and say they need help. Training for medics (and actually, most health care providers) is woefully inadequate when it comes to chronic pain – something that seriously needs to be addressed internationally.
Thanks for dropping by, and do let me know if there is anything I can discuss on here that you’d find useful.
cheers
Bronnie
Yes, I agree about the patients not being offered any other services. I am trying to be compassionate, while still guiding them toward the idea that they must participate in their own healing. Some are scared that they will be weaned off Norco/Vicodin etc that they have been taking for 10 years. We are just trying to find some way to plant the idea that being sedated is not the same as being well.
My training in this “chronic pain” has been “on the job”, reading guidelines and trying to understand what motivates people to take on the sick role.
I would love to see discussions on how to help patients move from wanting ever increasing opioids to wanting to be well. It doesn’t matter how great of a plan I can dream up if the patient is not remotely interested in healing/wellness.
Thanks,
Doe
Hello Doe, Please check out my website http://www.nancylaracy.com and see how I have coped with chronic pain. After suffering for many years from a connective tissue disease and fibromyalgia, animal assisted therapy ended up being the best treatment. I tried every other mainstream treatment and got some relief from massage therapy, chiropractic and a yeast free diet. Believe it or not, the sugar and yeast from all of the steroids I took for the connective tissue disease greatly increased the muscle and nerve pain. Gentle exercise eventually helped but not at the beginning. Everything in moderation. Regardless, I ended up with a cute, furry bunny that was born sicker than me. I spent so much time caring for him for nine years that I rarely had time to focus on myself. Bunnyboy ended up pioneering a medical treatment at the world famous animal medical center in NY that ended up saving my life. Check our story. My new therapy bunny Muffin and I hope to goto Newtown Ct next week to help out up there. Trust me, I am still in pain but the bunnies are miracle therapies for me. I had so many reactions to Ambien and the opiates that I am terrified. Johnson’s foot soap also in a hot tub is also terrific short term. Regards, Nancy Laracy
Hi! What a great idea – having an ‘introduce yourself’ page.
I stumbled across your site before, and then lost it, and am so glad I found it again! 🙂
I am a chronic pain patient who founded a website for people with TMJ disorder.
We are in desperate need of evidenced based research. I try to apply some of the things I read on blogs like yours to how I blog on TMJ Hope.
In any case, I am currently doing research on behavioral pain management techniques like meditation, CBT, mindfulness therapy, etc for some articles on the site.
Anyway, thanks so much for your blog! Now that I’ve found you again, I’ll make sure to subscribe this time! 🙂
I am a physical therapist who has chronic nerve pain, and treats patients with chronic pain. I can relate to this patient population’s frustration, and understand their story because they are me!
I periodically look around on the web to see what is out there regarding chronic pain, and happily happened upon your site. I will certainly be back often!
Hi Cindy
I’m glad you made it here, there are lots of clinicians from all around the world who find their way to my blog, and we also collect on Facebook if you’re interested in being on there. I personally love the Neuroscience and Pain Science for Manual Physical Therapists group – SO many wonderful links!
cheers
Bronnie
Thanks for the suggestion. I will check it out on facebook. I am going to be starting a chronic pain support group in my area, and suspect that I will use all of the resources I find here for myself and others.
I have noted that you post research that clinicians are working on–I am in the final stages of getting my manuscript approved for my doctoral degree, and my defense is just around the corner. I did a 3 year research project on patient-clinician communication, comparing expert and novice clinicians–the theory being that the communication that happens during treatment sessions is foundational to the success of the technical intervention, and that experts are doing something better or different than novices in this regard. I would love to share the results once the final version is approved. Would you be interested?
Hi.
I am Chhandashree from India and I came across your site while I was searching some material on CBT. I found really helpful links from adiemusfree’s post.
Thanks!
=D
Thanks so much! It’s lovely to find out where people come from and how they find my blog. I love writing it and it’s helped me make connections with so many people. Please feel free to drop me a line if you want me to look at any area in particular. I may take a while to write about it, but I will!
cheers
Bronnie
I was researching for Hypnotherapy for chronic pain and I run across this website. Needed some info to find out how to go about getting the treatment. I am an RSD patient with no relief from medications and physical therapy. Need to find a doctor in South Bay, Torrance area.
Thanks,
Shukria
Hi Shukria, I’m sorry, I don’t live in the US (I’m in New Zealand), and I don’t have any knowledge of various practitioners in different countries. You may find that mirrorbox therapy is helpful rather than hypnotherapy, although a combined approach may also be useful. I’ve written about both of these on the blog, if you search using the terms ‘hypnosis’ and ‘mirrorbox’ and CRPS you may find something useful. I don’t give advice to individual patients on here for numerous reasons, but I do wish you well in your search for help.
cheers
Bronnie
I’d like to introduce myself. I’m a doctor of chiropractic with an interest in chronic pain. The main methods I use are varieties of manual therapy, not because I think these methods are the “best” (nor do I believe they’re complete in and of themselves) but because I feel that’s a specialty I have to offer to those suffering with chronic pain.
In particular, two specialties of mine are craniosacral therapy (widely known) and bindegewebsmassage (much less well-known). I have my own name for bindegewebsmassage – Neurotactile therapy. I find that it’s effective because it taps into those aberrant connective tissue-central nervous system feedback loops that get thrown out of whack with chronic pain.
I’ve also come to place the phenomenon of chronic pain more and more within the context of the other chronic degenerative conditions of western lifestyle (heart disease, arthritis, dementia, depression, cancer, diabetes) and have also tried to approach chronic pain from a nutritional/lifestyle perspective.
But I’m only one guy. And as a DC I sometimes feel I’m out of sync with the larger medical world and the multidisciplinary approaches that would be more effective when delivered in a cross-disciplinary setting.
My practices are in NYC and Princeton, NJ, so if any readers are in those areas, I welcome contact.
I’m looking forward to benefiting from the wisdom on your site.
Ron Lavine
Hi Ron
Thanks for introducing yourself! I hope you enjoy what I write, and feel free to comment. I look forward to you dropping by.
cheers
Bronnie
May I republish your post “It’s there and there’s nothing I can do about it…” about problems subsequent to knee replacement? I think my readers would appreciate it. Of course, I’d credit you and provide a link back to your blog.
I also have a by-subscription-only e-mail information series on chronic pain. With your permission, I’d include this post as one of my e-mail series.
Here’s my blog if you want to check it out: http://www.yourbodyofknowledge.com
Thanks for your consideration. Ron
Hi Ron, that’s absolutely fine. One day I’ll learn how to use Creative Commons and post with those limitations, but in the meantime I’m really happy for you to republish. cheers
Bronnie
Hi. I am a nurse and a PhD student in behavioral sciences in Norway. My research group is studying the effect of a web-based (smartphone delivered) intervention (with feedback based on Acceptance and Commitment Therapy) on catastrophizing thoughts in women with chronic widespread pain following an inpatient rehabilitation program.
I have really enjoyed visiting your site for the last couple of years. Thank you for sharing your experience and wisdom!
Best regards,
Ólöf Birna
That sounds like such interesting research, please do keep me updated on how it goes. I’d love to have a guest post, if you’d like to, when you have some early results. And thank you for your very kind comments, it’s amazing where the people who read my blog come from!
I am currently working on a paper regarding the short-term effects of this intervention – I would love to share the results a bit later on. Thanks again for a great website!
Thank you again, and it would be great to have a post from you about your research. I’ll drop you a line shortly. cheers Bronnie
Dear Ms. Thompson,
Hi, my name is Jana Hamik and I am a registered nurse and chronic patient who lives in Northern California. I love your site both as a medical professional and as a person who has lived with chronic pain for over 23 years. It is great to see a site that is disseminating such pertinent information to those in the medical community who work with chronic pain patients. It’s such a great resource! I also love how user friendly and navigable your site is. I facilitate a support group for people living with chronic pain and while your site is directed to professionals, I have included Health Skills on my list of online resources for my group members who are interested in the research behind some of the coping skills that are commonly recommended to them and that we explore during our meetings.
I am also in the process of starting a blog on chronic pain (specifically for people living with chronic pain) and I have determined that I quite like the Structure theme from Organic Themes. I noticed that you have use this particular theme for your blog. I was hoping that you might be willing to share with me whether you have the free version or the premium version and also how you find working with this theme?
All the best, Jana Hamik
Just found your blog and really like it. I am a registered rehabilitation nurse RN QRP and also myself have a chronic disease. I have found the bulk of chronic disease online support groups and blogs are full of people feeding off one each others negativity so I created a blog to offer hope and try to keep people positive and motivated in their well being. I would like very much to add your blog to my blogroll if that is ok with you. Thanks for all your posts here. I’m going to keep reading
My blog:
http://positivera.wordpress.com
Hi I am an OT who works in injury management., I find the topics in your blog really interesting. I also have a blog you may like to have a look at. It is for injruy management professionals and my aim is to have a resource of information available for people on the site. Please feel free to visit and comment.
http://www.rehabhub.com.au
BJ Erkan of Bothell Integrated Health. We do medically necessary massage. Our specialty is soft tissue treatment in whiplash injuries. Working with folks that are in significant pain and coaxing them out, and teaching them how to live without it are my passions…as well as teaching in general.
I taught for some years at Bastyr University, in Seattle and Bothell Washington.
Would you like to be Facebook friends? Do you have a facebook page or recommend any that cover your subjects?
Thank you for this website:)
Hi Bronnie,
I am a massage therapist in Bothell, Washington, USA. I am actively mentoring 15 massage therapists in a clinical setting. We have over 130 combined years of experience. I personally have logged over 23,000 hours. I have also taught massage technique, theory, and physiology at Bastyr University. I am absolutely enthusiastic about manual therapy and love teaching as much as I love learning about the human body and the mind/body union. Your blog is quickly climbing to the top of my “favorites list”.
Please keep the posts coming:)
B.J. Erkan, L.M.P.
http://www.bothellintegratedhealth.com
Hi there,
Nice to meet you. I have been following your blog for a few months now. I am an OT and also a lawyer. I find the material you include in your posts extremely usful and well written.It should be read by anyone working with people who have suffered compensible injuries (as I do). Thanks for everything.
Robyne http://www.rehabhub.com
Thanks so much Robyne! if you’d like access to the OT only, drop me a line, it would be good to have your input in some of the discussions. I also hope you’re part of the “OT4” groups on Facebook – it would be wonderful to have your viewpoint in these discussions too.
cheers
Bronnie
Woops, I just realised that my URL is wrong. it is rehabhub.com.au.
Hello,
I am an OT in Ottawa, Canada. I just happended to stumble across your blog today. I’m blown away! What a fantastic resource. I will definitely be back!
Thank you!
Sarah
Hi Sarah
Thanks so much for your kind comments. I’ve sent you the password for the OT only area, there’s not a lot in it but I do occasionally get the urge to rant!
kind regards
Bronnie
Hai.. I’m a former OT from Indonesia (no longer practicing) but I’m interested in studying OT further – i’m interested ini analysis activity and OT role in obstetric and gynecology cases
i’ll visit your blog more offten after this and recommend this blog to my OT friends
Welcome to the blog! It’s great to see people from around the world getting interested and involved in helping people with pain.
Hello
I’m in Dorset, inthe UK and I’m an occupational therapist who used to work in mental health and then in a condition management programme (people with ongoing conditions wishing to return to work). I work now as a health and well-being coach (privately) including with people who have received all available treatments and want to get on with their lives, with or without continuing symptoms. As a coach (trained in cognitive behavioural coaching) I don’t offer ‘treatment’ for any condition but I do my best to stay on top of research in a range of areas that are relevant to my clients. I work from a background of CBT, occupational therapy,behaviour change theory and motivational interviewing, solution focused approaches and positive psychology. Thanks for a great site.
Thanks so much Sally! I love the connections I make with people around the world and especially occupational therapists who have found the passion for pain management. We can offer the people we work with so much, and those people deserve more than they usually get from a medical/cure-oriented health system. Sounds like we have some common themes in terms of the approach we take with people, and I really hope I can offer you things that might be useful to you 🙂
You already have!
Hi Bronwyn
My name is David Robertson and Linda Robertson (unrelated, other than I was her student:-) referred me to your blog. I’m an OT educator living and working in Scotland. I read your biog and I also qualified in 1984, completed an MSc in Ergonomics and I’m currently working on a PhD. I’ve been in contact with Linda as I’m interested in thinking and reasoning, and the experience of new graduates and she has kindly assisted me with a couple of queries. I’ve spent the evening looking at your blog and I’m very impressed. I’d like to refer my students to it next academic year, if that would be okay.
Hi Bronnie,
My name is Nicolás Sepúlveda, I’m a chilean PT, living in Santiago, Chile. I notice your blog thanks to Neuroscience and Pain Science for Manual Therapists facebook group and the Soma Simple floks. I have 4 years as a professional and now I’m starting to specialize in chronic pain and I’m very much interested in cognitive behavioral therapy, so if you could suggest me a book (or a couple) with really basic and practical foundations to understand and apply CBT that would be great, because although your blog and others have lots of information, sometimes I get a bit lost in that ocean of files, sheets, posts, comments, websites, blogs, facebook groups and so on. By the way I think your work it’s great, really patient-centered and not disease/syndrome-centered, without egos, with an open mind and evidence-based approach, keep the good work!
Thanks so much for your kind words, I’m glad I can help you!
Hi
I’m a clinical hypnotherapist in the UK working with chronic health conditions including pain management. I stumbled across your blog on the subject while looking for other blogs to reference in the hope my blog would begin to get real people reading it rather than bots and spammers! Certainly enjoyed reading that post although it is a few years old now and much more research has been done. Looking forward to reading the other posts in the Coping skills section, keep up the good work 🙂
Hi Pete, I know what you mean about spam and bots! I’ve enjoyed writing about coping strategies, and I’ll be revisiting some of these older posts once I’ve completed my PhD (the end is in sight – Christmas 2012!).
I’ll read your blog! Humans are out there, but it’s sometimes hard to find them.
Hi! What a great resource. I am a clinical exercise physiologist working in the area of chronic pain in Calgary, Canada. Thank you for your thoughtful and evidence based entries.
Thanks so much Shannon, I’m glad you’ve found it helpful. I’ve been a little lax recently because I’m working on my PhD – hence fewer posts than in the past. Once I’ve completed that hurdle, I’ll be back again!
Hello,
I am a chiropractor and I often search the web for new topics, and came across your website which I find highly informative. Chronic pain patients are very challenging cases; most of the time they have run the gamut of conventional and alternative medicine. But I welcome them, and do what I can to help them.
I also author a blog on musculoskeletal pain, http://PainandInjuryDoctor.com. I envision having any healthcare practitioner who has developed a particular pain relief technique or process that they are having success with, share their technique on my site, preferably accompanied with a video. If approved by the editorial board, they would get a short bio and link to their site in return. It would be like EHow, but more technical. Video instruction is the wave of the future; there are a lot of people out their who could benefit from our knowledge.
Roberta Stack-Costantino
I have been an Occupational Therapy Assistant for over 25 years. I lost my brother 31 years ago, and in 2011 I wrote a book, “Coping With the Loss of a Sibling: I Miss You, Gary,” to help others cope with the loss of a sibling. I started speaking on this topic, then became Certified in Grief Counseling and Life Coaching. I now speak on Coping Issues, Women and Wellness and How to Help your Loved one with Dementia. I was doing some research for a seminar and stumbled upon your website. I Love It!!! Thank you for the wonderful information. I would love to talk with you about what you do!
Hello all,
I am offering just a brief introduction here. I have been a practicing OT for 25 years in multiple areas. I am also a yoga instructor and meditator. I am getting ready to begin a private practice blending my experience garnered from these past 25 years. I am reaching out to begin following some colleagues and their work in the field of body and mind interactions, reduction of suffering and promotion of well-being, purpose and life satisfaction. I will update more as i launch this new phase in my life, and look forward to being part of this community. much warm wishes regarding your PhD completion and also looking forward to future blogging. You offer excellent resources!
moira
Hi guys ,what agreat work.i am an occupational thearpist based in nairobi kenya and recently involved in the evacuation procedures from battle field in the war tone somalia.have leant the hard way wht the original pioneers of o.t as proffesion saw and decided to come up with this proffessions during the first word war.food for thought is that splinting can help alot in pain management especially where there are fractured bones and tone soft tissues.keep on good job in this blog .its a big achievement for me to have found you people.
duncan
Excellent idea to have the practioners introduce themselves.
I am a chiropractor in practice for 15 years. One of the things I would like to emphasize is that the field of chiropractic has over 200 different recognized techniques. Thus, while one approach may not work for a give patient, another approach may be very successful. I personally use a computerized instrument to gently mobilize fixated joints. This allows significant flexibility in the force used so that it can be best suited to the tolerance of any patient.
Hi there
I’m enjoying reading your site. I’m about to start OT school–later in life after a couple of other careers. I’m interested in persistent pain and motivational counselling among other things.
All best,
Jeanette
I am an entry level COTA/L from Decatur, GA.
Thank you for a wonderful site! Your blogs are on target. NZ and Australia seem to have some great chronic pain treatment going on. Here in the USA people mostly want a pill or surgery to “make the pain go away.” Same where you are?
I’m a psychotherapist in private practice in Boulder, Colorado. I use CBT, mindfulness, Gestalt and a mix of tools and come from having knocked off 50% of my own, formerly disabling chronic pain problem. I run a chronic pain group here.
There’s so many differing opinions, like the old tale of the “Blind men and the Elephant.” It’s hard to know when we get success, what’s placebo vs. just idiosyncratic.
I wonder about John Sarno’s approach. How many people have been helped by it, vs. how many have tried and not been helped? He claims miraculous success as do many of us clinicians.
All the best and keep on what you’re doing that works! Charles
Hi Charles, so sorry for taking so long to respond to your lovely comment. I’m not sure that we are much different from your country – we still have enormous waiting times, multiple procedures, surgeries, and meds, but there has been a strong move towards interdisciplinary teamwork from our national insurer, so that’s helped.
As far as I know, John Sarno’s work has never been peer reviewed, nor subject to RCT hence I’m not keen on it. Also I have great concerns that he essentially suggests that tissues hold emotional “memories” – but it’s brains that do that, rather than tissues IMHO! Certainly I could see that people who receive a great deal of emotional support might gain courage to engage in things they haven’t for a long time, but I think that’s true for anyone, and is probably why physiotherapists often get results – because they offer support while people do things they’d normally be afraid of.
Whatever the mechanism, I think it’s important we try to learn about it, deconstruct it and polish the “active” bits so we can do more to help people who have chronic pain.
Thanks again for sharing!
Hi, Bronnie! I’ve commented on some of your posts on Facebook and visit your site increasingly often. It’s about time I introduce myself formally. My name is Kate, and I work as the only PT on an interdisciplinary pain management rehab team in San Francisco. I started following your blog after meeting finally meeting Neil Pearson in person this year. Thank you for all your insights and knowledge; it is a pleasure to read your writing and I appreciate feeling smarter for having followed what you post!
Hi Kate
Thanks for introducing yourself! Always lovely to “meet” people via my blog. Neil is awesome, and I haven’t ever met him but hope to next year when I tour North America (around end of May). So far going to Chicago, Vancouver and Alberta I believe. Maybe we’ll meet too!
Hi, Kate: I’m a psychotherapist specializing in chronic pain treatment and I moved here to Boulder after having lived in the Bay area for decades. I wonder if you know or have heard much about Michael Moskowitz, MD, psychiatrist in Sausalito?
http://www.neuroplastix.com/styled-4/styled-4/mhm.html
He’s the only person I’ve noted who really takes action on neuroplasticity and the “pain is in the brain” research-backed principal. He has specific, idiosyncratic brain oriented prescriptions. But I don’t know what results he has had really, with this pretty new direction. I wonder if you’ve seen his patients or know anything.
Best, Charles Horowitz, Ph.D.
charleshorowitzphd@yahoo.com
Thanks for your reply, Bronnie! I’m with you mostly on Sarno, but am an open-minded skeptic. Just because something hasn’t been peer-reviewed or had RCT doesn’t mean it doesn’t work, and when I hear anecdotes, even if it’s placebos at work, I consider them….For example, penicillin in the form of molds was used to fight infection for millennia before it was understood scientifically.
Thanks for your blog! Charles
Yes, I agree with you – it’s just that he’s been putting this stuff out there for years, but no-one’s picked it up for RCT. I’ve heard a lot about the “lightening process” here in NZ – another sort of therapy for chronic pain with remarkable results.
But of course, it could just be great rapport with people, giving them hope, and letting their brains do the wonderful work that brains do!
Yes!
Hello Bronwyn,
I have found your site both informative and refreshing. I am interested in your blog for two reasons. Firstly, I have recently been diagnosed with Trigeminal Neuralgia, and have had a very quick introduction to the world of pain management! Secondly, I am interested from a student’s perspective, I am a second year Occupational Therapy student at the University of the Sunshine Coast, Queensland, Australia. My journey over the past 4-5 weeks has been very interesting from a student’s perspective, and I believe it has set forth a pathway into helping people with pain management.
Nora
It’s great to see you’ve found my blog! I do hope it helps you in your own journey, and I also hope it helps inspire your future direction as a clinician (my cunning plan has worked LOL).
Hi Bronwyn
great blog, should be compulsory reading for all MDT working in pain.
BW
Bob Lewin
Thanks so much for your kind words Bob. I try to keep waving that flag!!
cheers
Bronnie
Hi Bronwyn,
I can’t actually remember how I came across your blog, but I have found it really interesting and informative.
I am an OT working in Sydney Australia, primarily in the area of community rehabilitation for people with acquired brain injury and other complex and catastrophic injuries.
Another part of my work is providing medico-legal opinion on personal injury matters, most of which involve chronic pain, although some of the people I see for rehab who have been involved in trauma also have chronic pain issues.
One of the things I really struggle with is assessing people who have suffered from chronic pain conditions (including CRPS), considering how this impacts on their ability to participate in roles and activities and then trying to formulate what I believe their care needs are for the rest of their lives. Whilst it is all well and good to recommend interventions (therapy, equipment, environmental modifications) at that point, my assumption is often that it is unlikely things will change dramatically if they have already experienced the pain for 2, 3, 4, 5 years already. I also struggle with the effective and legitimate use of outcome measures in such an assessment, as you only get to see the person once. I would be interested in your opinion. Happy to continue this conversation privately if you are willing.
Inbal
What an extraordinarily difficult task to do, because CRPS is both a complex problem, and affects people so profoundly. While Lorimer Moseley and colleagues have put forward the idea that CRPS can be eliminated using graded motor imagery and mirror therapy, in reality I haven’t seen nearly such good results. What I’ve seen is some improvement while in clinic, but this doesn’t transfer as well into real life. Once I’ve finished my PhD defense (this Friday!) I would like to look at this a little more. I’ll touch base via email,
cheers
Bronnie
Hi my name is Alex Blazhevskyiy. I am a recruitment and business coach working with small healthcare businesses. I am passionate about giving you, health business owners control of your businesses and showing how to get the returns you really deserve. In February I have a FREE webinar coming up “Discover 5 Secret Ways To Attract High-Quality Healthcare Staff To Your Health Business Reliably and Predictably In Under 30 Days”. Sign up for this not-to-be-missed healthcare recruitment webinar here if you like to participate. Good luck for 2015!
HI! Visiting you from Chicago, Illinois, USA! I am a licensed professional counselor and fitness specialist, and I often work with people (including myself!) who are attempting fitness activities with chronic pain. Many times, the psychological component of pain serves as the biggest obstacle to continuing a fitness regimen despite chronic pain. I’m online researching, and came across your blog. Thank you!
Hi Jill, welcome to the blog. You might be interested that I’m going to be touring North America in the middle of the year, and I will be running a workshop in Chicago on how to use psychosocial approaches within physical health (chronic pain). Give Sandy Hilton from Entropy Physical Therapy a call. She’s on Facebook if you’d like to make contact with her via there.
cheers
Bronnie
Hi I am from the Philippines and what brought me to your website was your post on the Chronic Pain Acceptance Questionnaire. I am conducting a study on Chronic Illness Acceptance (derived from the CPAQ) and I would like to ask help from you regarding the use of the said questionnaire and how you scored it based on a 6 point Likert scale. Please help! Thanks.
Hello-
My name is Keith..I am a PT from Colorado trying to learn more about pain and pain treatment strategies.Thanks for sharing your thoughts and insights.
Hi Keith, thanks for introducing yourself, it’s great to see so many people from the biggest trout fishing area of the world coming to my blog! I hope you don’t mind me sharing some of my pix about fishing in the High Country in NZ LOL
Let me know if there’s anything you’d like me to write about, I’m keen to make sure that what I say is useful.
Any pictures of NZ are welcome LOL…I visited there and loved your country and the people who i have met from there, our community is a ski town so we have quite a few kiwis here living in perpetual winter, As far as writing, anything that can help me further understand and help people in pain, and especially communicating that with other medical professionals…sometimes you feel like the lone light in a dark and windy place with all of the prevailing messages from other professionals and society in general..Thanks
Keith, I do medical psychology counseling in Boulder CO and am looking for “enlightened P.T’s” and others here to refer to and collaborate with. I lead a bi-monthly chronic pain colloquium for professionals. Please contact me if you would, Charles
charleshorowitzphd@yahoo.com
Hi, I have been suffering from chronic testicular pain since a vasectomy 3 years ago. I have found some measure of relief in Fascial Stretch Therapy and I’m lucky to live in the same town of one of the few practitioners of this therapy in NZ. If you suffer from any muscular pain issue you may want to consider talking to Holly Lynch about Fascial Stretch Therapy, it has certainly helped me.
https://www.facebook.com/holly.m.lynch?fref=ts
I’m really glad you’ve found an approach that’s helping. It’s a shame that fascia can’t actually stretch – but perhaps it’s the hands-on aspect that is helpful?
Hi. I’ve only been following your blog for a couple of weeks now but am finding it helpful. I’m a massage and Bowen therapist,based in the UK, and I’ve been actively following the clinical application of pain research for maybe 3 years now. I’m sure that you and your readers are aware of just how profound the implications of all this is for bodywork therapists. We really are being asked to fundamentally re-examine the way we approach our work but I believe we have to be guided by what the science is telling us. Thanks for your blog.
Thank you so much! I’m glad you’ve found it helpful. Believe me, massage and bodywork therapists are not the only ones who have had to revise what and how they do things in the face of pain science! I think it’s revolutionising pain management and all I hope is that people are able to get effective, compassionate help when they’re bothered by their pain, whether it’s chronic or acute. Thanks for getting in touch!
Hello,
Claire Cote here. I’ve been a RMT for 17 years and I live in the Vancouver area of British Columbia, Canada. When I saw your upcoming course listed in our professional studies area, I immediately reserved my seat.
As I therapist I have always tried to encourage my patients to take responsibility for their part in their healing with active therapy and I mostly have a collaborating approach, although if needed, I will get tough on people.
Three years ago, I had a debilitating spinal nerve impingement and went on my own healing journey. I have steadily made my way back to my practice and I have learned the importance of many factors acting on chronic pain beyond what is happening in the physical body. I can tell you, it has been very interesting to observe myself, as the patient and the therapist going through this process!
I now want to expand my knowledge and skills in pain management, so I can be of the most benefit to my patients and minimize the impact chronic pain has on their life.
Thanks for your blog and the accompanied information and I look forward to meeting you and listening to all you have to share.
Cheers,
Claire
Hi! I’ve been working as a massage therapist for about 15 years now and the most challenging part of my work at this point is knowing how to talk to clients about their pain – especially if I am telling them something that sounds different than what their doctors have told them. I really appreciate your blog and collaborative approach. Also, knowing it will take some time before people are ready to take in the new information we are presenting is helpful. I am an American working in Austria so I have the addition challenge that this information is coming from a foreign non-doctor, so I really want to hone my communication skills so my message – and my listening skills – come across in the best possible way -Thanks for your great information.
My pleasure!
Hi. I’m from the patient side of the exam table. I’ve been diagnosed with rheumatoid arthritis since 2008 and have since had three joint replacements, two spinal fusions, and a multitude of soft-tissues and varying RA treatment approaches. Pain is a chronic condition in the RA community and it’s wonderful to see such a holistic and, especially, caring attitude toward it. Thanks for an enjoyable blog (with brilliant photography).
Hi Carla, I’m delighted you’ve visited and introduced yourself. I know RA can be incredibly painful (my partner has ank spond but (lucky him) has responded brilliantly to a disease modifying drug), and one of my aims is for people who work in pain management to remember that we are PEOPLE first, not an “other” or “them”. By remembering that I hope clinicians will learn to respect what people say, act on what people say and include people in their own healthcare.
If there’s anything you’d like me to blog about, please let me know. I’m in the process of developing an online course for clinicians so they can learn effective communication and just what “patient-centred care” is supposed to look like.
Oh and thanks for your lovely comment about my photography. I started doing it when I was recovering from a post-concussion syndrome, and it’s kinda got away from me! My partner and I visit some stunning places in NZ, so the camera is never very far away.
Hi Bronwyn,
I’m involved with education for manual therapists & your name keeps popping up on my FB & Twitter feeds so I’m here to learn more 🙂
Malc from the UK
Hi Malc – be careful, I’m like a virus, I spread – muahahahaha!!! Thanks for connecting, and let me know if there’s any info you’d like me to find out for you. My passion is getting the research findings out there into practice, and being person-centred, honouring the humanness in us all. Hope you enjoy and have fun. cheers Bronnie
Thanks Bronnie.. & look forward to meeting you in San Diego next February!
You bet Malcolm!!
Hi, my name is Peggy Artman and I’m the volunteer Outreach Coordinator for the Retrain Pain Foundation. I have been following your blog for a little while and when I mentioned it to one of the co-founders, Elan Schneider, he spoke highly of your clinical skills. So I decided to introduce myself and the Retrain Pain Foundation in case you haven’t already heard of it.
The Retrain Pain Foundation is a non-profit foundation dedicated to providing free online pain education. At this time, the website features a series of 8 short lessons that teach cutting edge pain science concepts and pain self-management strategies through an engaging style with minimal text. As a chronic pain patient myself (I’m not a clinician), I can tell you that when I accidentally found this website some of the things I learned finally made sense about what was going on in my brain and body. The information was so helpful to me that I wanted to help out in any way that I could, so I’m working as a volunteer to let bloggers and other organizations know about this excellent resource.
Retrain Pain is always seeking opportunities for collaboration with bloggers or other organizations and would love to be in touch further. They are also having a Symposium in early March where there are some excellent speakers lined up for healthcare and wellness professionals.
Best Regards,
Peggy Artman
Outreach Coordinator, Retrain Pain Foundation
I’m so excited to see that you’ve got in touch! I do know the Retrain Pain Foundation – it’s an excellent resource for people living with pain. Would you like to write a brief blog post on it for me, and I’ll post it on here? It would be so cool to spread the word.
cheers
Bronnie
Hi! I would be happy write a blog post, but I’m checking with Elan at Retrain Pain to see if he wants me to do this. I will let you know. I also have a link to the the page on their website that could be posted on your website. I’ve saved it in PDF format too if you want to use that. I do know that they would be most appreciative if you could post a link to Retrain Pain’s website somewhere on your website. In return they will post a link to your website and we will put you on the e-mail list so you can stay informed of future events. It is very nice to meet you and I’m looking forward to reading more of your blog posts.
Hi
I’m a kiwi physio working in USA….who started out as a “manual therapist” trying to address pain issues but am now more a ” patient pain educator”, though I still have much to learn. One of the great insights regarding the treatment of pain came from a psychiatrist in Christchurch NZ, who said “if you only look at them as a physical being and don’t consider the cognitive, emotional component of a patients pain and its impact, your not treating the patients pain issues” Started me down a whole different path.. Your site is a great resource. Hopefully we can meet up when I’m back home for a visit.
I think I might know who you’re talking about!
I’d love to catch up when you’re in town again, and thanks for dropping by.
best wishes
Bronnie
Hi bronnie,
I am just getting in contact because a freind of mine Scott Peterson from Winchester belives you may be able to help/work with me. If your intrested please feel free to send me an email.
I had a motorbike accident in 2013 and got type 2 in my leg and foot and have not walked since. I now have centralized pain in two thirds of my body.I have had CRPS type 2 for the last two and a half years. I have just met a new physio who bullied me into starting Pain exposure physical therapy, I’ve had a look on the web and all I can find is trials are being done in Holland with CRPS type 1 but I can find no mention of type 2 CRPS. Do you know if any research has been done with Pain exposure physical therapy with CRPS type 2.
Cheers
Brodie
I’m a physiotherapist working in Canada. Earlier in my career, I received advanced training in orthopaedic physiotherapy and acupuncture, as well as teaching in the orthopaedic stream. The longer I worked, the more I was referred complex, challenging patients. Frustrated by the lack of success with using a traditional approach with these patients, as well as struggling with numerous personal pain issues, I started reading as much as possible on pain science.
I think I initially heard your name through the SomaSimple site. I’ve enjoyed reading the information on your site. I’m involved with the Pain Science Division of the CPA and look forward to hearing you speak at the Unconference in Toronto later this year.
Aaron
Hi Aaron
thanks for dropping by! Yes, I’ve been in and out of SomaSimple (fantastic group of people!), and writing this blog for a long time, so there’s plenty to read. I’m also on Facebook so if you want to connect please do.
When I visit Toronto I hope to run a workshop for people as well as speak at the Unconference, so will be talking to Bas to see how to get that conversation started and plans in place.
cheers
Bronnie
Sounds good.
Hi
I’m an OT in the deep south of NZ, currently doing a post-grad paper in vocational rehab. Have a few clients coming in to see us on return to work programs with complex pain etc and finding the short timeframes for the programmes challenging in terms of making progress with some clients.
For my assignment, I’m thinking about (theoretically!!) designing a new service for pain based on an early triage system (and I need to rationalise why the early detection of those likely to develop chronic pain would be beneficial). Any references would be great.
In the meantime, will keep reading the posts as it’s really useful to use in my practice, thanks!
Hi!
I’m a pain psychologist in San Francisco. I enjoyed your blog on a new definition of pain.
Warm regards,
Sue
Thanks Sue, I hope you enjoy reading the rest of my blog – it’s a labour of love!
best
Bronnie
Hi Bronnie , I’ve just come across your blog – and will definitely keep coming back. I live in Ireland and have recently completed my teacher training with Breathworks in the UK, and now I can teach Mindfulness for Health (also known as Mindfulness Based Pain Management) – so finding your blog has been really the highlight of my day!
Kind regards
Paola
Hi Paola, that’s so exciting, I love what Vidymala and her group are doing. She’s been a pioneer really with developing mindfulness for people living with chronic pain. Please keep dropping in and if you have questions you’d like answered, do drop me a line and I will try to write a blog to answer it. I’m currently working my way through blogging about Mastering the Clinical Conversation by Villatte, Villatte and Hayes, and learning a heap as I do it. Keep in touch!
Bronnie
Hi Bronnie,
I’m a Aussie physio living in London; have really enjoyed listening to you on the multiple podcasts you’ve done with the pelvic guys and others. Just wanted to reach out to say thank you for the time you have/are putting into spreading the word on all things pain and function – it’s made a definite difference to the way I treat (for the better I hope!). I wanted to ask if it’d be ok if I link to your site from my blog? katstene.com
Best, Kat
Of course!
Hi, Patty Butts Ph.D in Holistic Nutrition, author, passionate about helping people recover physically and emotionally. Former LPC and believer that almost all mental health begins in the gut. Love emotion code.
Hello: I am a Physical Therapist living on the Mississippi Gulf Coast (US), long ago university trained and fellowship trained in manual therapy which offered, along with continuing education, much more insight into patient management, although have long sought further help for that group of patients that traditional medical and rehabilitation rationale have had less than impressive results. I have read/purchased most of the “pain” texts of recent years with varying impressions of the material and its application to the average clinician trying to give it his/her best go on a daily basis. While I have only recently perused your site, it strikes me as a much more balanced, insightful and clinically meaningful guide than some of the texts/sites published by say the more entrepreneurial authors out there. Best to you all down under!
Thanks so much! This is a great way to make sure pain stuff is global!!
Hi I am so glad I have found this blog.I am an osteopath working in the UK having qualified in 2000 but I would say only started the BPS aspect about 8 years ago through NOIGROUP, Bodyinmind and the work of Louis Gifford and Peter O Sullivan.
Like many who embark on this never-ending journey of pain knowledge I have become rather obsessive, perhaps driven through love of learning, enjoying the challenge to my belief systems, wanting the best for my patients and probably a lot of ego.
It is so interesting but overwhelming in the degree of information out there and the fact many aspects are only half baked so you feel somewhat of a pioneer.
It has led me to carry out further studies in Cognitive Behavioural hypnotherapy, Cognitive functional therapy, Graded Motor Imagery and I am currently on my way to Holy Isle in Scotland to do a week’s retreat as part of an MSC in Mindfulness and Compassion ( University Aberdeen distance learning).
However despite all this I have great difficulty in the treatment room stringing all the parts together.That is why it is such a great blog as it is intelligent but immensely practical.Although I give patients a gratitude diary I love the idea of a worry diary and will bring that immediately into practice.
This journey is quite challenging as you feel patients expect an “osteopathic” treatment and trying to move myself away from my old habits is very hard.Also I need to earn a living and I’m not sure what my reputation would be like if I went with this with everyone- there is also a bit of a bias towards using it on those you perceive as intelligent enough to understand it.Plus apart from one colleague I don’t know anyone else who works this way.
So thank you for joining a community of like minded individuals.
Brilliant stuff and I will attempt to put lots more into practice like you say best as one drop at a time.I will also try and get as many practitioners/ patients to read your work.
Well done and many many thanks
Graham Yates (www.grahamyates.com)
Hi Graham, and thanks for such a wonderful introduction to your journey to pain geekdom, and for your lovely words about my blog. I’m so pleased it’s been useful for you – and don’t worry I’ll keep blogging!! cheers Bronnie
Hi, Bonnie- So happy to have found your blog- your writing is very captivating! I have only read a couple of pieces thus far, but am looking forward to delving deeper.
I was diagnosed with a spondylolisthesis when I was fifteen and have navigated the waters of do’s and don’ts from a variety of doctors, physios, chiros, etc., truly appreciating now in hindsight how debilitating the delivery of diagnosis/information can be if handled improperly! I am now quite certain the secondary symptoms that have developed from being told how to behave (posture, core strengthening, anti-extension, etc) have had a more dramatic impact on my health than the original structural abnormality.
Anyway, I am a new chiropractor in the states, awaiting licensure, with ample time to continue to broaden my perspective and pursue what resonates. I appreciate this in-between time when every day takes me on delightful paths such as finding your two pieces on exercise and pacing. The difference between my regimented academic schedule six months ago and my current whimsical research schedule seems to bear a resemblance to how you differentiate between “gym” exercise and “life” exercise (if I may summarize your definitions so haphazardly!). I hope to not learn so much I render myself incapacitated as a practitioner 🙂 Half kidding.
Keep up the great work!
Nate
So lovely to read your comments, and I’m really glad you’ve found my ramblings helpful. I’m a bit passionate about helping clinicians do better for people living with pain – we can, and we are beginning to learn that people are people, not lumps of muscle and tendon, and because of this we need to engage with who we work with in a partnership. How cool is that?!
Pardon me… BRONNIE. Autocorrect is the culprit, I swear!
😉
Hi there, I’m also an OT , there is something I would love to run by you re pain and FM , is it poss to DM? I’m on twitter occulife
I’m a Massage Therapist in Wellington. Interested in learning more about pain science, the biopsychosocial approach in working with clients, widening my conceptual field, learning more from other allied health professionals – after all we are all working to benefit our clients through our own professional practice. I love this blog – it shares so much that really resonates with me, how I practice, how I want to grow further as a health practitioner.
Hi! I’m in pain & found your blog via the UK’s NHS Pain Toolkit website. I experienced a prolapsed disc at the base of my neck at the start of the year & it’s absolute agony! I’m currently held together by strong painkillers & having physio. It’s such a frustrating & sleep-depriving experience when I’m used to instructing fitness classes & doing lots of activities myself. Trying to be a patient patient!
We’re often not very good at being patient patients!! I’m lousy at it. All the best for your recovery.
Hi Bronnie! I live with persistent neck pain and LOVE your blog, podcast interviews etc. I find the holistic perspective you have so encouraging. I was a teacher and am a freelance journalist; however I’m continuing training with Breathworks in the UK Thisbe year to become a Mindfulness for Health teacher. I also want to teach somatic movement and write about pain and how to live well with it. I live in Whistler, Canada, though I hail from the UK. I love hearing about the psychological strategies we can utilize each day to live well with pain. Thanks for all you do!
Hi there! Really enjoy this blog and posted resources, thank you!!!!
I am a current physical therapy student and wanted to share a book project that I have been working on. I just published an eBook about my journey of recovery from CRPS/chronic pain following a knee injury and the subsequent surgeries that followed. You can buy the book on Amazon: “Moments from a Year of Healing: A Book of Memories and Essays”:
You can read it on the FREE Kindle App on any computer, tablet, or smart phone:
https://www.amazon.com/kindle-dbs/fd/kcp
This injury is what inspired me to go to PT school! My hope is that by sharing my story, it may help provide some insight to healthcare professionals who work with chronic pain patients as well as to help those going through similar experiences of coping with chronic pain.
I would appreciate any feedback that you might have on this writing project of mine as well as sincerely request that you pass along the book to anyone that you think might benefit from my story of recovery from injury. Thanks so much!
-Leda
p.s., I also blog about physical therapy related topics at: https://sapiensmoves.wordpress.com/
Hi Bonnie, I’m a PTA and LMT in Corpus Christi, Texas and I naturally attract folks with chronic pain (go figure). For 23 years now I’ve looked for tools to help people have some fun in their body and move on- thanks for sharing your many ideas to enrich …
Hi Bronnie,
I appreciate your blog as I continually learn more about pain. I’m a clinical nurse specialist in MS, and have fallen into learning about pain, especially neuropathic pain, by also becoming the UK trainer and distributor in Action Potential Simulation ( APS ) therapy, ( a specific type of micro-current therapy) after having started a very successful clinic in the MS Centre that I work at.
I now get asked to speak on pain to other MS health professionals, and begin my MSc in a few weeks. I couldn’t find an affordable local MSc in pain management so I am doing advanced clinical practice in nursing, and hoping to focus my options on pain. So that’s why I appreciate your blog, as it’s self-directed learning for both practical application and my own education.
I also use Bach flower remedies and HeartMath biofeedback stress resilience technique in my clinical practice. My MS blog is http://www.mirandasmsblog.com and there’s more about APS Therapy on my commercial website, http://www.painfreepotential.co.uk
Thanks for listening!
Miranda
Thanks so much for introducing yourself! This blog is a labour of love… but I hope some of the ideas will resonate with people like you, as we work from within to change the way health is practice, and pain is conceptualised.
Greetings. I’m a medically retired OT from Sydney. Im now full-time patient with autoimmune diseases and hemiplegic and brainstem migraine.
I recently started attending a multidisciplinary pain clinic, so Im learning a lot about modern pain theories. Of course I can’t help but look through OT eyes even though I have been off work over a decade, and they don’t have an OT on team. I’m interested therefore in your work.
I admin facebook groups for autoimmune and migraine patients, in fact this is one of my roles within Migraine Australia, as Community engagement coordinator. So I need to keep up with informative and accurate information to share with our members.
Hi Carolyn and welcome to the blog! I understand seeing the world through our occupational therapy lens – it’s something we can’t ever seem to lose! The Sydney programme doesn’t have occupational therapists, you’re quite right, and it’s an omission I regret very much. We seem to have become somewhat invisible in that particular environment – but there are occupational therapists in the Burwood Hospital programme (where I worked for many years), and in many other programmes too. I wish you all the best for your journey dealing with these challenging pain problems. We don’t have all the answers but we’re certainly getting to a better place with understanding people who are going through it all.
Dear; Dr. K. S., D.P.T./SFVAHCS introduces yourself. I appreciate your work(s). Smiles, Robert.
Dear Dr. B. L. T.; I am keenly interested in awareness. Am told, “Pain is lost consciousness,” by a brilliant esquire L. C. G. SBCO, CA. Would one agree? Was poisoned, very likely, by
1. amikacin
2. hygromycin
3. ketamine
4. chloramphenicol
5. melengestrol
6. sulfanitran
7. ipronidazole
8. spectinomycin;
And, I understand all-you-all mostly work w/the fascia and not the circulatory or the organs. Is it known at all:
Tendons become weakened from the ingestion of these eight (8) above poisons? More likely to tear? Like when a cooked turkey leg maintains it’s tendon-joint-bone-attachment integrity, Yet looses all connectiveness when the meat having been eaten off the bone, And, the bone is simmered in a slow pot of broth? Does the fascia of the human body suffer loss of tendon-joint-bone-attachment integrity from the ingestion of any known poisons?
Thanks. Smiles, Robert.
Hi there Bronnie!
Wow! I feel like I have found a home in your blog. I am an occupational therapist in South Africa. Managing patients who suffer from persistent pain from a biopsychosocial perspective is still a really new concept here. I feel that occupational therapists have so much to offer in this context and are an integral part of the pain management team (although these teams do not really exist here yet). The concepts you talk about are all quite new here and most clinicians tend to shy away from chronic pain patients because they don’t know how or what to offer them. I am in private practice doing functional capacity evaluations. An integral part of my work involves helping people get back to work, despite their pain. I have loved reading your blog and have found your ideas and concepts really encouraging. I also really appreciate the links you have to relevant resources and literature. Thank you!
Thank you so much! I think occupational therapy and persistent pain management are natural allies – and I also think occupational therapy and ACT are philosophically aligned. There are a few facebook groups that might also be helpful: Pain4OT, Pain OT, Exploring Pain: Research and Meaning, ACTivating Occupational Therapy – enjoy!
Wonderful, I will definitely have a look at these. I am a member of Pain4OT and that is actually where I came across your name and a link to your blog.
The onset and continuation of low back pain (MVA and age-related degeneration) forced me to abandon my work as a hospital nurse and private carer / therapist. I have since found purpose and fulfilment in assisting people in living a life of quality and meaning as a coach and counsellor through my practice Heart and Soul (https://www.heartandsoul.co.za). Numerous fully facilitated email workshops make this special assistance available to the house-bound and has a fine history of success and support for those who most need it.
Hi. I am an Occupational Therapist working within the private sector via Vitality360 and in the NHS. Both in the UK. I have worked in the clinical field of Pain and Fatigue for longer than I care to remember! I am particularly interested encouraging those with lived experience to share their stories.
I have started contributing to blogs and tweeting via Vitality360 over the last 12 months or so. it seems to be a great way of connecting with others.
I love your blog and will signpost others to it
Bev
Kia ora Bronwyn
I’m an Occupational Therapist working in Kirikiriroa/Hamilton and I love that you’re offering your wisdom on Pain Management. I see that Linda Robertson and Merolee have also commented above. They were my tutors (a while ago now)!
Morena Mana, So lovely “meet” you! Both Linda and Merolee have inspired and enthused so many occupational therapists over the years – Merolee once wrote to me when I was newly grad (way back in 1985) after I’d written a paper on using MOHO in groups for older patients. We then connected when we were both doing our PhDs. I contributed a book chapter to Linda’s book on clinical reasoning in occupational therapy. So their legacy lives on. Wonderful women I’m proud to know.
I a New York City born American. Came up the hard way when I didn’t think it was hard.
Drive a taxi 7 days a week and went night university at Hunters College
Got enough credits to enter the University College-of Osteopathy in London.
41 years after graduating I am still practicing.
70 years older I still do a full list and teaching.
I have 7 children and 4 grandchildren. I live my work
Hello Dr. Bronnie, I have just been intrigued and delighted by the wealth of resources on your site here. I am an occupational therapist and health & wellness coach working with veterans (Wisconsin, U.S.); our Whole Health team programming is going in the direction of pain science and self-management of chronic pain, but we also welcome all seeking to grow and address wellbeing. It has been exciting to support our vets with education, biofeedback and battlefield acupuncture so far. The hospital supported two of us to be trained in clinical hypnosis and now we are working to define what this will mean in the unique role of occupational therapy (neither of us are psychologists). I see that you wear many professional hats, so am wondering in which role you are operating when you offer hypnotherapy. Any specific insights or leads as we develop services with this intersection of hypnosis and occupational therapy? Peace and all good, Chris
Hi Bronwyn, nice to discover your blog. I’m a fellow Kiwi (living in Spain), with a clubfoot and one leg shorter.
I’m constantly adjusting my routines to be as well as I can… but these last few months have been… interesting. We’ve been stuck inside an apartment for close to a year now, and my pain exploded. So after lockdown, I sought out a good chiropractor, who reduced the pain and taught me a lot. It’s interesting that chiropractors were never mentioned during a decade of surgeries and specialist appointments. But it turns out they can make a lot of progress with feet. In the clubfoot facebook groups I see people struggling so much with pain, and some even getting their foot amputated… but very few know that chiropractors might be a route worth trying. Best of all he’s teaching me to manage it better myself.
I love what you said about CBT should be part of an accessible public health approach. It would be amazing for this to happen.
I’m not here to complain or be political, but I think this story is worth sharing… A few years ago I tried to get an appointment to figure out if there are any further steps I should be taking re clubfoot, hip pain etc. I was doing everything I could think of to be proactive, but my pain was increasing, and people were starting to say I should get onto it while I’m youngish (30). Well, I visited my GP, who sent a letter to the CDHB… and the response I received simply said, “this is not a priority for the us at the moment”. It was so disheartening and shocking… to try and be proactive so that I can have a reasonable quality of life and not become a burden on society, then to be fobbed off like that. All I wanted was a discussion, assessment if necessary, or some guidance. Anyway, I’ll continue to do my own research and try new things, but I feel it would be super valuable and cost effective (keep people working and off disability benefits etc). Even a 10-year followup survey or single assessment could probably make a difference in reducing severe future problems.
Anyway, I’ve enjoyed reading your blog so far, and will continue to! I’m keen to try everything I can to reduce my pain. I also started my own blog during lockdown, to share the things that worked for me, so other clubfoot and one leg shorter folk can get an idea of things that might be worth trying (not medical advice, just my experience). If you’re interested, it’s https://embracingimbalance.com/
Thanks for making this blog, it’s super valuable!
Dear Dr. Thompson, I applaud your ongoing efforts and research, which you make available so selflessly to the general public. As both a Chronic Illness Coach / Counselor and long-term challenge with chronic pain due to lower spinal damage, I find frequent solace and support in your professional and elaborate reflections, thoughts and researched information. With my very best wishes.
Thank you so much, it’s partly for myself (helps me clarify my own thoughts and check research literature) as well as trying to help improve the way people with pain are treated in our healthcare systems.