Does early stress or adversity increase the likelihood of chronic pain for kids?

The short answer is “it’s unclear”; but as a pediatric pain psychologist and researcher at Boston Children’s Hospital (Boston, MA, USA), I am currently looking to increase our understanding of this relationship. Historically, going through certain stressful experiences in childhood (also known as Adverse Childhood Experiences [ACEs]; abuse, … [Read more...]

What does best-practice patient education look like?

It comes as no surprise to any health professional that one of the most important, time consuming and arguably, most rewarding aspects of our practice is providing ‘advice and education’ to our patients. This may include discussing their concerns, teaching skills and in many cases re-educating unhelpful beliefs and behaviours. What I found very … [Read more...]

Announcing the 2018 EPIC scholarship

We started the EPIC scholarship back in 2015 and awarded the first three winners for the Abdominal and Pelvic Pain Conference of 2017. The entire purpose of the EPIC scholarship is to help other people have the opportunity to attend a conference that would normally not be possible.  While not all conferences are created equally, every conference … [Read more...]

The Opioid Epidemic and the State of Pain Management

Opioids and opioid policies have received increased attention over the last year in light of the “opioid epidemic.”  Opioid overdoses and deaths have reached staggering numbers and have led to a prevailing belief that opioids and people that use opioids are “bad.”  This perspective has unfortunately been a distraction from a crucial problem: poor … [Read more...]

Upper extremity exercise in people with Rheumatoid Arthritis – does EXTRA help?

It is well known that exercise is good for health and wellbeing - but is it OK to exercise if you have painful joints caused by an inflammatory arthritic condition? This is a question that concerns many people with Rheumatoid Arthritis. Rheumatoid Arthritis affects about 0.5% population globally and, although advances in drug treatment have … [Read more...]

Better than what? Any treatment for back pain can be effective… it might just depend on what you compare it with

Was my treatment helpful, benign or harmful? Consider the common clinical scenario – a patient presents complaining of pain. You decide to administer a particular treatment. Over time the patient’s symptoms improve. Do you then succumb to bias and presume your intervention facilitated their recovery? Do you consider the possibility that recovery … [Read more...]

It’s time for a shake up: Driving system wide change to improve musculoskeletal pain care and outcomes

Shaking it up Most of us working in the pain field know the many challenges well. Challenges are widespread, reaching from the health systems (macro) level, downstream through service delivery level and into the clinical (micro) coalface. How can we approach this complexity to achieve person-centred care and respond to the escalating burden … [Read more...]

When can you say you are well again? How do people with Complex Regional Pain Syndrome define recovery?

Complex Regional Pain Syndrome (CRPS) is diagnosed according to a clear and distinct description of the signs and symptoms of the condition [1]. Clinician observations and patient reports are used and reaching a threshold “score” determines a positive diagnosis. This all seems simple enough, and, for the majority of patients, the signs and symptoms … [Read more...]

Take a step back to understand muscle behaviour in chronic low back pain

There is a popular belief that chronic non specific low back pain (CNSLBP) patients need to have higher activation of their trunk muscles during simple functional tasks in order to stabilize their spine. Changes in pain and disability, however, do not seem to be mediated by deep muscle activity changes targeted by some exercise interventions during … [Read more...]

Self-efficacy and paradoxical dependence in chronic back pain

Chronic back pain is one of the most common medical problems patients experience, and it may also be psychologically and socially disabling. People with chronic back pain are significantly more likely to experience depression, anxiety, and other mental health conditions than the general population. I wanted to get a deeper appreciation of how … [Read more...]