Great blog posts by people I respect

First up from How to Live with Pain – Making positive psychological changes – including acceptance.  Just don’t put a timeframe on it, is my opinion.  Acceptance doesn’t mean you have to like your pain, it just means you let it be there without judging it.

You just HAVE to go to Dr Rob’s Musings of a Distractible Mind.  He always makes me laugh and think all at the same time!  Beware of grammatical elitism – those who would say that by ‘wantonly leav[ing] out spaces betweenwords and endanger the very fabric of the spacetime continuum by doingso’.  You decide whether healthcare should be two words or one… OK?

Psychology of pain – for hours of reading pleasure – Through this blog I found this link to ‘Overlapping Conditions’ – things like chronic fatigue syndrome, endometriosis, fibromyalgia, interstitial cystitis, irritable bowel syndrome, temporomandibular joint all overlap to a great extent.  Mohammed Yunus writes about these and describes them as central sensitisation disorder – worth a look.

Go on, take a look at Science-based Medicine blog – if anyone has EVER thought I was opinionated, think again – this is opinionated, and GREAT!  Don’t read it if you’re into energy healing or mythology of autism and immunisation, or any of the other myriad health fraud or woo disinformation that’s around.

Don’t panic, if you’re not mentioned here – it doesn’t mean I don’t love ya, just need more time and energy!!

Thought-provoking posts on science, health and beliefs

The blogosophere is pretty hot right now – some really interesting topics being discussed, enough to make me think again about my own biases.

The first one is the popular Science-Based Medicine blog that rarely fails to challenge those that prefer ‘belief’ over ‘evidence’ – do not proceed to this blog if you think homeopathy or reiki is ‘good for your health’, this blog does not mince words!  Three posts have particularly caught my eye recently – this one on some of the reasons people (even scientists!) find it hard to change tack when new evidence is found; this one on the misinterpretation of acupuncture trials; and this one on the role of adenosine in pain relief.

The first post really struck me as I look at my own bias towards nonbiomedical interventions – yes, even I can be tempted to ‘overlook’ studies that show equivocal findings for CBT-based approaches, or to focus on studies that show positive outcomes… I remember my initial concern about mirror therapy and graded motor imagery for CRPS – and while I still hold concerns that this treatment doesn’t seem to reduce pain and increase function in many people (notably the complex presentations we see at Pain Management Centre), I do think it holds promise for people with CRPS now that the evidence is gathering.  That’s science you see – revising what we accept in the face of accumulating evidence.

Movin’ Meat is the rather curious name of a blog written by an ER physician (and administrator, bless him).  This blog is often about    but this post is a repost and hilarious.  Do not read if you’re easily offended, but given that people with chronic pain DO have a sense of humour (how would you survive without it?!), this post on a Brand New Pain Scale hit my funny bone – read and enjoy!  After my experiences last year with tonsillectomy, I totally appreciate the need for a ‘beyond what I want to cope with’ number on a pain scale.   I’ve always thought that putting a number to my pain is a bit silly, wouldn’t it make more sense to start with ‘no pain’, move to ‘a bit of pain but it’s not bothering me’, go from there to ‘yup, this is pain and I’d like it to go no’ and finally ‘I’ve had enough, MAKE IT GO AWAY’.

And lucky last, but certainly not least, is BodyinMind blog and the rip-roaring debate going on there about exercise and back pain, and the most recent discussion about acupuncture and a critical review of some of the most recent papers on it in pain management.

If you’re a Facebook participant, head to the very informative and rational page Neuroscience and Pain Science for Manual Physical Therapists.  If you click on this link and you are not a member of Facebook, beware, you won’t be able to get in.  If you’re clicking on this at the Canterbury District Health Board, forget it, Facebook isn’t available.  Otherwise, click away and enjoy the discussions on a whole range of neuroscience and pain management topics.  Some fabulous people and over 2500 fans have joined this page and comment regularly – makes Facebook worth visiting just for this alone!

I hope you enjoy these links – let me know what your thoughts are!

Grand Rounds – medical/health blog carnival

While I’m on a roll and linking to good carnivals, grand rounds has been published for a long time now – it’s a roundup of fabulous posts of a medical or health-related nature. It’s often hosted at different sites, so to keep up with it I find I need to remember to go to the current one and put a reminder on my Google Calendar (not advertising OK, NOT!!!) to where the next carnival is being hosted.

In browsing Better Health, I just found the Grand Rounds calendar – the limitations of WordPress strike again, and I can’t load the widget here (I think), but there is a calendar and you can always find the Grand Rounds location at Better Health.

How often do you turn to journals for information?

If you’ve been a browser through my blog you’ll see that I’m an information junkie.  I just can’t help myself – if there’s information out there, I want to look at it!  I regularly get journal contents pages sent to me, browse the ‘article in press’ sections of e-journals, use MedWorm RSS and generally get immersed in research.

I’m lucky in a way, because I can access the medical library from my laptop at home or at work, so it’s easy to keep up – what would it be like without this ease of access?

Anyway, the thought crossed my mind that I’m not sure how often other clinicians do this foraging around to find out what is going on in the literature.  So today’s post is really about the reasoning loop that I use and when I head off to read about what to do with a specific patient.

These are the times I definitely go searching-

  • a patient with a presentation I haven’t seen often (eg Marie Charcot Tooth)
  • a patient who is not responding the way I expect (have I missed some important piece of the case formulation?)
  • a patient with a combination of symptoms or diagnoses that might influence each other (eg PTSD and chronic pain)
  • when I want to confirm that I’m on the right track with an approach (eg using hypnosis and biofeedback to change limb temperature)
  • when another team member is using an approach I’m not familiar with (eg motor imagery for CRPS)
  • when I want some resources so I can present something in a different way (eg visual layout for goal setting)

And of course, loads of other times!

I also find myself going through the literature when I want to confirm to myself that an old ‘tried and true’ strategy actually has the research to back it rather than folklore!  A good example of this is a period of time where I looked for information on activity regulation or ‘pacing’ – sadly there isn’t much published on its efficacy, so it’s much less common for me to use this than I did before I reviewed it!  And it’s one of the more common tools of pain management, especially amongst occupational therapists.

I carried this review process out again recently when looking through the literature on goal setting.  In this instance I found a lot of support for the process of goal setting – in principle – but fewer examples of outcome studies in chronic pain management.  So once again, we don’t actually know whether goal setting makes a difference to outcomes for people with chronic pain.

I think the next phase of work in pain management will be to unpack the ‘cognitive behavioural approach’ and investigate the components to identify which parts ‘work’ and for whom.  And I’m not the only one to think this!

The challenge for clinicians in finding research to support their work is that there is little discussion or exploration of how research actually translates to clinical practice.  The ‘how to’ part of using a strategy effectively is often not well described in research papers.  Some research refers to an administration protocol, but few go into any detail as to how this protocol works, how it was provided to clinicians, how closely clinicians followed it.

I hope that this will be an area I’ll develop in this blog over time – it’s certainly something people who have completed my survey (to the left, at the top of the page!) have asked for.

If you’re new to my blog, I write most week days, you can bookmark and visit, or you can subscribe using the RSS feed above.  If you’re new to RSS click on this link to learn more.  I do love comments – and usually respond quickly (I’m always excited when someone talks to me!).  If you’d like an area to explore in more depth, let me know and I’ll find some links to put up.

For those who may be concerned: I’m not paid to do this, I have no advertising, I have no sponsors, this is not my job!  Any opinions expressed are entirely my own, not my employers.  It’s a labour of love, helps me review the literature – and link with people who are into pain management as much as I am.  Maybe one day I’ll get famous and be paid to do it, in the meantime it’s my pleasure.   I hope you enjoy it too.

Way cool sites to visit!

I’m not really seriously blogging at the moment, just strolling through random sites, and coming across some funny stuff.

One page to go to is Attractors – enjoy moments of fun-filled timewasting by moving the tiny balls around so the even tinier balls bounce and swirl!  this came courtesy of The Cleverest which has moments of hilarity and some rude bits too.

If you have some time, head over to Flickr for some stunning photography.  Some of the photographers I particularly like are Joojo and KiwiGaL – both producing completely different but amazing works. (more…)

101 Fascinating Brain Blogs at Online Education Database

Take a look at this list of great sites on things ‘brain’ – from lighter to really intense, at least one or two of these blogs will have something for you!

While you’re there, the Library holds a range of really good material to inspire you and inform you, especially if you’re taking an on-line education course.

The Kreativ Blogger Award


Thanks to How to Cope with Pain who has just given me the Kreativ Blogger Award!
Each winner of the award gets to list six things he or she is happy about.
Now that’s a pleasure!

  1. It’s Friday, so I get to hunt out Friday Funnies (coming up later today).
  2. My cat is sitting on the end of my bed, and I’m blogging in bed (and it’s 8.15 in the morning!) – she’s turned away from me because I kicked her off the newspaper while I was trying to read it.  Why do they sit right in the middle of the newspaper?!  She’s gorgeous, and has the most amazing purr.
  3. I have some beautiful roses in the garden at the moment, and they smell divine.
  4. I have the luxury of being able to ‘do academic’ today and write, which I absolutely love.
  5. I’m returning my library books today so I get to choose another 5 FREE reads! My bookshelves are thankful, they are groaning because I am truly a bibliophile of great magnitude.
  6. I’m taking my camera out to do some flower macro shots later today, and I just love my photography. (more…)


A couple of interesting sites to drop into over the weekend – I took a look at PsyBlog and what a wonderful video I found there! This one is about the Psychology of Magic – three critical techniques that good magicians use to trick the audience.  Makes me wonder whether people that believe in psychics should read it and be just a teeny bit more critical of their performances…

Ever wondered what type of person bothers to write a blog?

Well, wait no longer – there’s an answer for you!  Clinical Cases and Images posts about Who Blogs – Personality Characteristics.  What did they decide? ‘According to the … studies … people who are high in openness to new experience (both men and women) and high in neuroticism (women) are likely to be bloggers.  Women who are high in neuroticism are more likely to be bloggers as compared to those low in neuroticism. There was no such difference for men.’

Hmmm, not so sure about the neuroticism (Who me? Neurotic? No way!!) – I wonder if anyone has evern checked out the characteristics of people who READ blogs?!!  And of course I wonder whether there’s a difference between this type of blog, and the blog of those who write about everyday life?

Now, settle down for a bit of news about pseques.  (Written like that to avoid the net detector treating this blog as something to block!).  Great post from one of my favourite sites, MindHacks – which was itself blocked at my workplace the other day for ‘criminal and undesireable’ information!  It’s about the medicalisation of normal human sexuality – some great information on how certain normal variances in human behaviour are pathologised by stretching the diagnostic criteria for one disorder to include behaviours in an entirely different area – and not always sensibly either!

Finally today, some people get just a wee bit titchy on Monday mornings, while others are bright and breezy.  This post from Positive Psychology News Daily talks about team energy – and suggests that emotions are contagious, especially if you’re the boss.  Well, I’m not the boss, but I can tell you this: NEVER get between me and my coffee cup!

A couple of geeky websites!

I just thought I’d post a couple of websites I’ve found over the past couple of days – using StumbleUpon. If you haven’t tried StumbleUpon, and you find yourself at a loose end, or just feel like ‘browsing’ the internet instead of watching TV, try it! Full of cool sites that show up randomly, or you can guide it by adding keywords for the areas you’re interested in.

Brain Explorer is a site put together by Lundbeck Institute. It has a wide range of information, but the bits I liked the most were the Brain Atlas section, and the gallery. Lots of great images, and relatively simple explanations.

Science Daily has a wealth of newsworthy links and posts. Headings of ‘Health & Medicine’, ‘Mind & Brain’, ‘Plants & Animals’, ‘Earth & Climate’ and more – videos, articles and images. Great reading, you can spend a long time on this site!

Zack Lynch blogs about Neurotechnology on Brain Waves. He lists a bunch of quite technical blogs that he regularly visits, as well as some links that are well worth browsing on Neuroresources. Latest blog entries include the Allen Spinal Cord Altas, What’s your Brain Age?, and a great video by Jill Bolte Taylor. Worth a visit!

And my final link for today – Changing Minds is a huge site with a whole bunch of information and links to factors that influence change. From Argument to Brand Management, Theories and Techniques, this site has plenty to keep you interested, especially if you’re curious about how to help people change. Definitely one to bookmark.

I hope you have a moment or two to spend perusing the links – they’re fun and you can spend lots of time just locating information, for the true information junkie like me!!

fMRI explained…

Hah! now I’ve never really understood fMRI except as a vague generalisation that it ‘shows blood flow which correlates to neuronal activity’.

This post found on MindHacks (see my ‘blogroll’ for the link!) leads to several helpful readings about what fMRI actually measures, how it does so, and more importantly, says ‘our understanding of what brain scanning data tells us evolves over time. A study conducted ten years ago might mean something different now.’

People who are sceptical of science will possibly sieze on this as confirmation that ‘you can’t trust science, it could be wrong’ – but for me, it shows how open science is to revision in the light of new information.

Anyway, that was an aside: head on over to the post, and check out some of the supporting readings, I think it’s helpful, albeit needing a little time to digest!