Flare-ups and how to handle them
If you live with persistent pain of any kind, you’ll know what a flare-up is. Periods of time when pain is exacerbated and sustained at a higher than average level over at least a few days, often longer. Flare-ups always settle down – but oh my, it can feel like they’re going on forever!
Handling a flare-up is not quite the same as handling everyday pain. Everyday pain, for those of us who manage it independently of healthcare professionals, usually needs a generally steady routine, not too many surprises. A regimen of movement, relaxation, fun, mindfulness, plodding on and managing stress. A little bo...
Source: HealthSkills Weblog - September 29, 2019 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Coping Skills Coping strategies Pain conditions Professional topics Resilience/Health exacerbation flare-up management flare-ups Source Type: blogs
Who am I? The sense of self in chronic/persistent pain
One of the most pervasive descriptions of what it is like to live with persistent pain is the loss of sense of self. Time after time in qualitative research we read about people feeling they’re in “limbo land”, losing confidence that they can do what matters in their lives, feeling stigmatised and isolated – not themselves any more. An in-depth meta-ethnography of qualitative research showed that pain undermined participation, ability to carry out daily activities, stymied a sense of the future, and intruded on the sense of self (MacNeela, Doyle, O’Gorman, Ruane & McGuire, 2015).
To und...
Source: HealthSkills Weblog - September 22, 2019 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Uncategorized Source Type: blogs
There are two of us in this …
Today’s post is another one where there’s very little to guide my thinking… Have you ever wondered why we read so much research looking at the characteristics of the people who look for help with their pain – yet not nearly as much about us, the people who do the helping?
There are studies about us – thanks Ben – and others! (Darlow, Dowell, Baxter, Mathieson, Perr & Dean, 2013; Farin, Gramm & Schmidt, 2013; Parsons, Harding, Breen, Foster, Pincus, Vogel & Underwood, 2007). We know some things are helpful for people with pain: things like listening capabilities (Matthias, ...
Source: HealthSkills Weblog - September 1, 2019 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Coping strategies Pain conditions Professional topics Research Science in practice attitudes beliefs communication nocebo Source Type: blogs
A Simple Way To Ease Lower Back Pain
This treatment is a traditional technique that can resolve chronic pain, fatigue and poor sleep.
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Activate: How To Find Joy Again By Changing What You Do (Source: PsyBlog | Psychology Blog)
Source: PsyBlog | Psychology Blog - August 29, 2019 Category: Psychiatry & Psychology Authors: Mina Dean Tags: Back Pain Source Type: blogs
Possible Way to Avoid Some Unnecessary Visits to Emergency Departments
I recently encountered an article that quantifies the resources expended by unnecessary patient visits to emergency departments (EDs) (see:Diverting avoidable emergency department visits could save healthcare $32 billion annually). Many such visits could have achieved the same results and less expensively in a physician's office. Below is an excerpt from the article:Diverting avoidable emergency department visits could save healthcare $32 billion annually. Primary care services rendered by hospital EDs come with substantially higher price tags than in primary care settings. Avoidable visits to emergency departmen...
Source: Lab Soft News - August 5, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Diagnostics Healthcare Information Technology Healthcare Innovations Hospital Financial Medical Consumerism Medical Education Preventive Medicine Public Health Quality of Care Source Type: blogs
Should you see a chiropractor for low back pain?
This study only included people who were willing to receive chiropractic care.
Even within the two groups, the care varied — that is, not everyone in the usual care group received the same treatment, and this can also be said for the chiropractic group.
If any of these factors had been different, the results might have been different. For example, it’s possible that if an older population of people with chronic low back pain had been studied, “usual care” might have been the better treatment.
Bottom line
This new study lends support for chiropractic care to treat low back pain. But it’s important to recognize th...
Source: Harvard Health Blog - July 30, 2019 Category: Consumer Health News Authors: Robert H. Shmerling, MD Tags: Back Pain Health Men's Health Women's Health Source Type: blogs
Opioids for acute pain: How much is too much?
In this study, the researchers looked at opioid prescriptions in 2016, and the numbers are shocking. In the US, 22% of prescriptions written by dentists were for opioids, compared with just 0.6% for British dentists, and US dentists prescribed about 35 opioids per 1,000 population, compared to just 0.5 opioid prescriptions per 1,000 population in England. Additionally, the opioid prescribed in England was a relatively weak codeine-like drug, whereas in the US the majority of prescriptions were for hydrocodone, a stronger opioid with greater abuse potential.
When does an opioid prescription make sense?
It is simply impossib...
Source: Harvard Health Blog - July 24, 2019 Category: Consumer Health News Authors: Scott Weiner, MD Tags: Addiction Pain Management Source Type: blogs
Barriers to good pain rehabilitation
This is a long…… readooops, sorry, not.
Low back pain is, we know, the greatest contributor to days lived with disability (Rice, Smith & Blyth, 2016). And no-one anywhere in the world has found a good mix of services to reduce the number of days lived with disability as a result of this problem. And yet billions of dollars are used to fund research into the many contributors to a shift from acute low back pain to ongoing disability associated with low back pain.
At the same time, treatments that directly target disability, rather than pain (a target considered the most important outcome by Sullivan an...
Source: HealthSkills Weblog - June 9, 2019 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Low back pain Pain conditions Research Science in practice health funding health systems models of care Source Type: blogs
The Easiest Way To Relieve Lower Back Pain
Surprisingly, this easy technique is as effective as following a dedicated muscle strengthening program.
→ Support PsyBlog for just $4 per month. Enables access to articles marked (M) and removes ads.
→ Explore PsyBlog's ebooks, all written by Dr Jeremy Dean:
Accept Yourself: How to feel a profound sense of warmth and self-compassion
The Anxiety Plan: 42 Strategies For Worry, Phobias, OCD and Panic
Spark: 17 Steps That Will Boost Your Motivation For Anything
Activate: How To Find Joy Again By Changing What You Do (Source: PsyBlog | Psychology Blog)
Source: PsyBlog | Psychology Blog - May 15, 2019 Category: Psychiatry & Psychology Authors: Jeremy Dean Tags: Back Pain Source Type: blogs
Clinical reasoning & meaning-making (a long post)
Clinical reasoning is a cornerstone of evidence-based healthcare, in fact some would argue it’s the cornerstone of all healthcare. While there are many different processes, the ultimate purpose of clinical reasoning is to ensure the person seeking help has their needs identified then met, and the clinician has a basis upon which to decide which treatment they should offer.
The approach we use in clinical reasoning, including the information we prioritise and search for, and the way we synthesise the information to make sense of it will depend on the model we have to explain our treatment approach. For example, if...
Source: HealthSkills Weblog - May 12, 2019 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Clinical reasoning Occupational therapy Pain conditions Physiotherapy Professional topics Psychology Research Science in practice embodiment intersubjectivity making sense persistent pain Source Type: blogs
Do you trust me?
Trust – something that needs to be earned, or something that is present at first… and then erodes? Or perhaps, it’s a snap judgement we make on the fly – and judge everything else about a person on that basis?
Firstly, why even discuss trustworthiness in pain rehabilitation? Well, the answer is quite clear: I don’t know how many times I’ve been asked if I can tell whether someone is faking their pain. I’ve read numerous articles on functional capacity testing – and its poor predictive validity (or completely absent investigation of such properties). I’ve had case man...
Source: HealthSkills Weblog - April 14, 2019 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Clinical reasoning Coping strategies Pain conditions Professional topics Science in practice empathy malingering stereotypes stigma trust trustworthiness Source Type: blogs
Always look on the bright side of life!
This study was carried out in mainland China, and is for this reason alone, is an interesting study (most of our understanding about pain comes from the US, Canada, Australia and the UK). China also faces an enormous burden from people being disabled by chronic pain, so this is a good step forward to understanding what might support living well with pain in this highly populated country.
The study is by Shuanghong Chen and Todd Jackson, and published last year in the journal Rehabilitation Psychology. The authors recruited 307 Chinese adults with chronic back pain (189 women, 118 men), and asked them to complete a batch...
Source: HealthSkills Weblog - March 31, 2019 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Clinical reasoning Coping Skills Coping strategies Research Resilience/Health Science in practice Low back pain positive psychology self efficacy Source Type: blogs
Medical care was never intended to be daily fights against insurance companies
Last month I saw Joan, a woman who has had low back pain for years. She ’d been through the ringer like every other person in severe pain: countless procedures and medications. She continued to have daily pain that stopped her from staying focused at work, playing with her kids or being the spouse or friend […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - March 27, 2019 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/robert-bonakdar" rel="tag" > Robert Bonakdar, MD < /a > < /span > Tags: Conditions Pain Management Source Type: blogs
Signs of Early Labor
A woman will experience many signs before going into labor: nausea, cramping, lower back pain and a thick, bloody discharge. While some of these may be concerning, in many cases it’s just the body’s way of telling you that actual labor has not quite started yet but is close!
During pregnancy, the uterus grows and stretches. If you think about it, the uterus needs the most room towards the end of the pregnancy to support the full-term baby growing inside. In this event, mom-to-be may experience cramping and lower back pain as the uterus contracts to adjust in the body. She may also experience nausea because the full-...
Source: Cord Blood News - February 26, 2019 Category: Perinatology & Neonatology Authors: Maze Cord Blood Tags: babies Cord Blood pregnancy Source Type: blogs
Reconciling uncertainty and the drive to diagnose
Recently it was suggested to me that even though I’m an occupational therapist, I might “diagnose”. Not so much diagnose disease, but “determine if a patient is depressed, anxious, catastrophising, fear avoidant etc?” The author goes on to say “isn’t that diagnosis too?” The comment was made in the context of a lengthy Twitter discussion about so-called “non-specific” low back pain. Over the course of I think about five weeks now, a large number of highly educated, erudite and passionate clinicians have argued the toss about whether it’s possible to identify...
Source: HealthSkills Weblog - February 17, 2019 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Back pain Clinical reasoning Interdisciplinary teams Low back pain Pain conditions Resilience Science in practice certainty collaboration diagnosis NSLBP uncertainty Source Type: blogs
