What to do with the results from the PCS
The Pain Catastrophising Scale is one of the more popular measures used in pain assessment. It’s popular because catastrophising (thinking the worst) has been identified as an especially important risk factor for slow recovery from pain (Abbott, Tyni-Lenne & Hedlund, 2010), for reporting high levels of pain intensity (Langley, 2011), and for ongoing disability (Elfving, Andersoon & Grooten, 2007). I could have cited hundreds more references to support these claims, BTW.
The problem is, once the PCS is administered and scored: what then? What difference does it make in how we go about helping a person think a ...
Source: HealthSkills Weblog - February 26, 2017 Category: Anesthesiology Authors: adiemusfree Tags: Assessment Back pain Clinical reasoning Coping Skills Coping strategies Education Low back pain Pain conditions biopsychosocial Chronic pain Occupational therapy pain management rehabilitation Therapeutic approaches Source Type: blogs
NYTimes: Lower Back Ache? Be Active and Wait It Out, New Guidelines Say
Dr. James Weinstein, a back pain specialist and chief executive of Dartmouth-Hitchcock Health System, has some advice for most people with lower back pain: Take two aspirin and don't call me in the morning.On Monday, the American College of Physicians published updated guidelines that say much the same. In making the new recommendations for the treatment of most people with lower back pain, the group is bucking what many doctors do and changing its previous guidelines, which called for medication as first-line therapy.Dr. Nitin Damle, president of the group's board of regents and a practicing internist, said pills,...
Source: Psychology of Pain - February 14, 2017 Category: Anesthesiology Source Type: blogs
The American College of Physicians integrates quackery with medicine in its recommendations for managing back pain
One of the overarching themes of this blog, if not the overarching theme, is to expose and combat the infiltration of quackery into medicine. What I’m referring to, of course, is the phenomenon that’s risen over the last 25 years or so in which various pseudoscientific alternative medicine therapies (but I repeat myself) have found… (Source: Respectful Insolence)
Source: Respectful Insolence - February 14, 2017 Category: Surgery Authors: Orac Tags: Clinical trials Complementary and alternative medicine Quackery Science Skepticism/critical thinking acupuncture American College of Physicians integrative medicine low back pain massage NSAIDs Source Type: blogs
Research and Reviews in the Fastlane 172
Welcome to the 172nd edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature.
This edition contains 5 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Justin Morgenstern and, of course, Chris Nickson. Find more R&R in the Fastlane reviews in the R&R Archive, read more about the R&R project or check out the full ...
Source: Life in the Fast Lane - February 9, 2017 Category: Emergency Medicine Authors: Jeremy Fried Tags: Airway Emergency Medicine Intensive Care R&R in the FASTLANE EBM Education recommendations research and reviews Source Type: blogs
What difference does it make to know about psychosocial risk factors?
The “psychosocial yellow flags” or risk factors for developing ongoing disability after a bout of acute low back pain have been promulgated in New Zealand since 1997. Introduced as part of the Acute Low Back Pain Guidelines, the yellow flags were lauded both locally and internationally and subsequently there have been many international guidelines which have adopted this kind of integration. But what exactly do we do with that information? How does it help if we find out that someone is really afraid their pain means something awful, or if they fear their life will never be the same again, or if they truly worr...
Source: HealthSkills Weblog - January 29, 2017 Category: Anesthesiology Authors: adiemusfree Tags: Clinical reasoning Coping strategies Professional topics biopsychosocial goal-setting healthcare Occupational therapy Pain physiotherapy Therapeutic approaches Source Type: blogs
End-of-year musings
It’s my last post for the year. It has been an extraordinary year, lots of surprises, shocks and enough excitement for anyone! I’m not even going to start on the political changes, here in NZ we’ve had yet another major earthquake, excitement as ACC (our national accident insurer) sets up new pain service contracts (with a LOT of people who haven’t been involved in pain management before… there’s an experiment in the making!), and continuing road cone carnage on the streets of Christchurch.
On the pain news front, I can’t think of any incredibly ground-breaking news – althoug...
Source: HealthSkills Weblog - December 18, 2016 Category: Anesthesiology Authors: adiemusfree Tags: Clinical reasoning Occupational therapy Resilience/Health Science in practice biopsychosocial disability Pain pain management Therapeutic approaches treatment values Source Type: blogs
Elderly Home Safety Checklist 2021
Conclusion
Aging in place gives senior citizens and elderly homeowners the freedom that is quite different from what they may experience in a senior facility.
Home care for seniors living with family members or caregivers or being visited regularly by professional home care service providers beats any accommodation in nursing homes.
Family members living with their aging parents can use the lists and safety tips discussed in this article when making a home safety assessment.
These home safety tips can help seniors, particularly those with chronic pain, lead dignified and independent lives within the familiarity of their ho...
Source: Shield My Senior - December 4, 2016 Category: Geriatrics Authors: Stevie Compango Tags: Senior Safety Source Type: blogs
What do we do with those questionnaires (ii)
In my last post I wrote about the Pain Catastrophising Scale and a little about what the results might mean. I discussed the overall score suggesting a general tendency to “think the worst”, with the three subscales of magnifying or over-estimating the risk; ruminating or brooding on the experience; and helplessness or feeling overwhelmed and that there’s nothing to be done. At the end of the post I briefly talked about how difficult it is to find a clinical reasoning model in physiotherapy or occupational therapy where this construct is integrated – making it difficult for us to know what to do d...
Source: HealthSkills Weblog - November 28, 2016 Category: Anesthesiology Authors: adiemusfree Tags: Assessment Chronic pain Clinical reasoning Low back pain Occupational therapy Physiotherapy biopsychosocial pain management Psychology Therapeutic approaches treatment Source Type: blogs
What do we do with those questionnaires?
Courtesy of many influences in pain management practice, you’d have to have been hiding under a rock or maybe be some sort of dinosaur not to have noticed the increasing emphasis on using questionnaires to measure factors such as pain catastrophising, depression or avoidance. The problem is I’m not sure we’ve all been certain about what to do with the results. It’s not uncommon for me to hear people saying “Oh but once I see psychosocial factors there, I just refer on”, or “they’re useful when the person’s not responding to my treatment, but otherwise…”, ...
Source: HealthSkills Weblog - November 20, 2016 Category: Anesthesiology Authors: adiemusfree Tags: Assessment Chronic pain Clinical reasoning Coping strategies Occupational therapy Physiotherapy Psychology Science in practice biopsychosocial goal-setting healthcare pain management Therapeutic approaches treatment Source Type: blogs
It ’s time to phase out the word “psychosomatic”
Psychosomatic. I learned not to use that word forty years ago, after I’d told a patient her malady might be psychosomatic in origin. She turned red, jumped up, and on her way out said, “I hope you fall into an open manhole and die!”
Well, maybe I should’ve been more circumspect. I hadn’t realized until then that people can understand “psychosomatic” in a different way than I do. I’d meant what I still do, that the mind can affect the body. She thought psychosomatic was code for imaginary, as though I’d said it was all in her mind. And I suspect most of us believe that psychosomatic mea...
Source: Kevin, M.D. - Medical Weblog - November 20, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/jeff-kane" rel="tag" > Jeff Kane, MD < /a > Tags: Conditions Psychiatry Source Type: blogs
CMS Issues Final Rule on CY 2017 Physician Fee Schedule
Conclusion
The CY 2017 PFS final rule is the latest showing of the Administration-wide strategy to create a health care system that results in better care, smarter spending, and a healthier population.
Related StoriesOpen Payments Having an Adverse Effect on Physician-Rep RelationshipsCMS Bundled Payments for Care Improvement Evaluation ReleasedCMS Releases MA and Part D Landscape Information for 2017 (Source: Policy and Medicine)
Source: Policy and Medicine - November 2, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
Hotshot. A supplement scam with a difference?
Jump to follow-up
The "supplement" industry is a scam that dwarfs all other forms of alternative medicine. Sales are worth over $100 billion a year, a staggering sum. But the claims they make are largely untrue: plain fraudulent. Although the industry’s advertisements like to claim "naturalness". in fact most of the synthetic vitamins are manufactured by big pharma companies. The pharmaceutical industry has not been slow to cash in on an industry in which unverified claims can be made with impunity.
When I saw advertised Hotshot, "a proprietary formulation of organic ingredients" that is...
Source: DC's goodscience - October 25, 2016 Category: Science Authors: David Colquhoun Tags: Academia supplements Bruce Bean cramp dietary supplements DSHEA Harvard Hotshot Muscle cramp Rockefeller university Rod MacKinnon TRP receptors Source Type: blogs
Hotshot. A supplement scam with a difference?
Jump to follow-up
The "supplement" industry is a scam that dwarfs all other forms of alternative medicine. Sales are worth over $100 billion a year, a staggering sum. But the claims they make are largely untrue: plain fraudulent. Although the industry’s advertisements like to claim "naturalness". in fact most of the synthetic vitamins are manufactured by big pharma companies. The pharmaceutical industry has not been slow to cash in on an industry in which unverified claims can be made with impunity.
When I saw advertised Hotshot, "a proprietary formulation of organic ingredients" that is...
Source: DC's goodscience - October 25, 2016 Category: Science Authors: David Colquhoun Tags: Academia supplements Bruce Bean cramp dietary supplements DSHEA Harvard Hotshot Muscle cramp Rockefeller university Rod MacKinnon TRP receptors Source Type: blogs
“ I know my pain doesn ’ t mean I ’ m damaging myself – but I still have pain ”
In the excitement of helping people understand more about pain neuroscience, which I truly do support, I think it’s useful to reflect a little on the history of this approach, and how it can influence the experience people have of their pain.
If we go right back to the origins of pain self management, in the groovy 1960’s and 1970’s – the first truly significant work in chronic pain self management came from Wilbert Fordyce (Fordyce, Fowler & Delateur, 1968). Bill Fordyce was a clinical psychologist working in the Department of Physical Medicine and Rehabilitation, University of Washington, Seat...
Source: HealthSkills Weblog - September 25, 2016 Category: Anesthesiology Authors: adiemusfree Tags: Chronic pain Clinical reasoning Education/CME Pain conditions Science in practice acceptance biopsychosocial healthcare pain management Research Therapeutic approaches Source Type: blogs
NCCIH: Co-opting “ nonpharmacologic ” treatments for pain as being “ alternative ” or “ complementary ”
I’ve been critical of the National Center for Complementary and Integrative Health (NCCIH), which was until relatively recently known as the National Center for Complementary and Alternative Medicine (NCCAM) ever since I first discovered that it existed, lo, these many years ago. When I first discovered NCCIH, what struck me is how much pseudoscience it… (Source: Respectful Insolence)
Source: Respectful Insolence - September 12, 2016 Category: Surgery Authors: Orac Tags: Complementary and alternative medicine Politics #talkpain acupuncture chronic pain fibromyalgia low back pain National Center for Complementary and Alternative Medicine National Center for Complementary and Integrative Health NCCAM NCC Source Type: blogs
