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Non-Invasive Pain Treatment Now In Illinois
Gracie Bagosy's condition is so painful the suicide rate is 68%. Yet after three years of failed narcotics, other drugs, and occupational therapy, her pain was finally controlled by a new non-invasive, painless, totally safe treatment. That treatment, currently under investigation at the Mayo Clinic and University of Wisconsin, has now reached Illinois. "When I came to Illinois for this treatment, I thought it was a hoax," says Ms. Bagosy. "Yet I knew almost instantly it was working...
Source: Health News from Medical News Today - July 12, 2013 Category: Consumer Health News Tags: Pain / Anesthetics Source Type: news
(472) Adolescents' change in functional abilities after completion of an intensive chronic pain rehabilitation program using subjective measures
The purpose of this research was to evaluate subjective measures of functional improvement within a pediatric chronic pain rehabilitation setting. Information was gathered retrospectively to observe progress made from admission to discharge during a 3 week intensive multidisciplinary program. The structure of the program offers three hours of physical and occupational therapy in group and individual sessions daily, primarily focusing on therapeutic activities that will promote return to age appropriate functional level.
Source: The Journal of Pain - March 27, 2015 Category: Materials Science Authors: H. Kempert, R. Pearson, S. Daghstani, D. Benore Source Type: research
Complex Regional Pain Syndrome: Evidence-Based Advances in Concepts and Treatments
AbstractPurpose of ReviewThis review presents the most current information about the epidemiology of complex regional pain syndrome (CRPS), classification and diagnostic criteria, childhood CRPS, subtypes, pathophysiology, conventional and less conventional treatments, and preventive strategies.Recent FindingsCRPS is a painful disorder with multifactorial pathophysiology. The data describe sensitization of the central and peripheral nervous systems, inflammation, possible genetic factors, sympatho-afferent coupling, autoimmunity, and mental health factors as contributors to the syndrome. In addition to conventional subtype...
Source: Current Pain and Headache Reports - July 8, 2023 Category: Neurology Source Type: research
Pacing – Activity management concepts (a longer than usual post)
This study used actigraphy to monitor movements, and correlated this data with self-reported pain and fatigue. This study found that “high pacers” had more severe, escalating symptoms, and activity pacing was related to lower physical activity. Karsdorp & Vlaeyen (2009) found that activity avoidance but not activity pacing was associated with disability, and challenged the notion that pacing as an intervention is essential in pain management. van Huet, Innes, & Whiteford (2009) on the other hand, found that “graduates” from a pain management programme continued to use pacing strategies...
Source: HealthSkills Weblog - August 3, 2014 Category: Occupational Therapists Authors: adiemusfree Tags: 'Pacing' or Quota Chronic pain Clinical reasoning Coping strategies Pain conditions Research activity disability pain management Therapeutic approaches Source Type: blogs
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
Teamwork: Gaps or overlaps?
For many years now, interprofessional/multidisciplinary teams have been considered the best model for delivering pain management. This stems from studies conducted right back as far as J J Bonica in 1944 (Bonica, 1993), and originally referred to teams consisting of several medical specialties. Bonica later initiated a multidisciplinary/interdisciplinary pain programme in 1960, including 20 people from 14 medical specialties “and other health professions”. In 1977, Bonica and Butler classified pain programmes into five groups – major comprehensive multidisciplinary programmes – more than six discipl...
Source: HealthSkills Weblog - May 13, 2018 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Interdisciplinary teams Professional topics biopsychosocial Clinical reasoning Health healthcare pain management Psychology Research treatment Source Type: blogs
Pain – or pain-related disability?
I’m struck at how often clinicians focus on pain intensity when how much pain intrudes on life matters more. I wonder whether new therapists might not have read some of the old studies looking at the relationship between pain intensity and disability – because while there is a relationship there, it’s not nearly as strong as we might think.
Let’s define a couple of terms first: pain is, I think most of us can agree, “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage”. (click for full definition and not...
Source: HealthSkills Weblog - October 3, 2021 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Uncategorized Source Type: blogs
Why I ’ m not fazed by unremarkable results in therapy trials
Remember the old ‘pareto principle’? 80% of the results come from 20% of the input, or as Wikipedia informs me, “the principle of factor sparsity”
I think we’ve got there with musculoskeletal pain, especially low back pain.
The other ‘law’ that might apply is that of diminishing returns.
We’ve learned a great deal about low back pain over my clinical career. We’ve essentially learned what not do to. In the name of progress, thousands of people have put their pain (their bodies) on the line. And progress has not exactly been great right? We’ve learned tha...
Source: HealthSkills Weblog - May 7, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Back pain Low back pain Occupational therapy Pain conditions Physiotherapy Professional topics Research Science in practice healthcare Therapeutic approaches Source Type: blogs
Why does “doing exercise” work?
Bless all the physiotherapists in the world, they keep us doing exercises. And exercises are good because they get us doing the things we want to do in our daily lives. But how does it work? This is not an exposition on exercise physiology – I’m not au fait enough with physiology to do that and there are many other people out there with vast amounts of knowledge giving us the benefit of their wisdom who have written at length about exercise and why it’s important. Instead I want to talk about some observations – and maybe pose some critical questions too.
For many years I’ve worked in a chro...
Source: HealthSkills Weblog - May 1, 2016 Category: Anesthesiology Authors: adiemusfree Tags: 'Pacing' or Quota Assessment Chronic pain Clinical reasoning Coping Skills Coping strategies Low back pain Occupational therapy Pain conditions Physiotherapy Psychology Science in practice pain management Research Source Type: blogs
Why does “ doing exercise ” work?
Bless all the physiotherapists in the world, they keep us doing exercises. And exercises are good because they get us doing the things we want to do in our daily lives. But how does it work? This is not an exposition on exercise physiology – I’m not au fait enough with physiology to do that and there are many other people out there with vast amounts of knowledge giving us the benefit of their wisdom who have written at length about exercise and why it’s important. Instead I want to talk about some observations – and maybe pose some critical questions too.
For many years I’ve worked in a chro...
Source: HealthSkills Weblog - May 1, 2016 Category: Anesthesiology Authors: adiemusfree Tags: 'Pacing' or Quota Assessment Chronic pain Clinical reasoning Coping Skills Coping strategies Low back pain Occupational therapy Pain conditions Physiotherapy Psychology Science in practice pain management Research 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
Targeting the people who need it most
This study provides some support for using single item questions to identify those who need more in-depth assessment, and those who don’t need this level of attention. I like that! The idea that we can triage those who probably don’t need the whole toolbox hurled at them is a great idea.
Perhaps the New Zealand politicians, as they begin the downhill towards general elections at the end of the year, could be asked to thoughtfully consider rational distribution of healthcare, and a greater emphasis on targeted use of allied health and expensive surgery.
Deyo, R. A., & Mirza, S. K. (2016). Herniated Lu...
Source: HealthSkills Weblog - May 28, 2017 Category: Anesthesiology Authors: adiemusfree Tags: Assessment Back pain Chronic pain Coping strategies Interdisciplinary teams News Pain conditions Professional topics Research biopsychosocial disability healthcare rehabilitation self management treatment Source Type: blogs
One-session instruction in pacing doesn ’ t work
In this study, the “tailored” group underwent seven days of monitoring using an accelerometer, the results were downloaded, analysed and an individualised pacing plan developed by the therapists. The plan was intended to highlight times when the person had high or low levels of activity (as compared with their own average, and averages drawn from previous studies of people with the same diagnosis), and to point out associations between these activity levels and self reported symptoms. Participants were then provided with ideas for changing their activity levels to optimise their ability to sustain activity and ...
Source: HealthSkills Weblog - February 25, 2018 Category: Anesthesiology Authors: adiemusfree Tags: 'Pacing' or Quota Chronic pain Clinical reasoning Coping Skills Coping strategies Occupational therapy Pain conditions Research function Motivation pain management self management Therapeutic approaches values Source Type: blogs
On the problem of coping
Coping. Lots of meanings, lots of negative connotations, used widely by health professionals, rejected by others (why would you need coping skills if you can get rid of your pain?).
I’ll bet one of the problems with coping is that we don’t really know what we’re defining. Is coping the result of dealing with something? Or is it the process of dealing with something? Or is it the range of strategies used when dealing with something? What if, after having dealt with the ‘something’ that shook our world, the world doesn’t go back to the way it was? What if ‘coping’ becomes a...
Source: HealthSkills Weblog - December 2, 2018 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: 'Pacing' or Quota Assessment Chronic pain Clinical reasoning Coping Skills Coping strategies Motivation Research Science in practice activity patterns flexibility Occupational therapy physiotherapy values Source Type: blogs
Pacing, pacing, pacing …
If there’s one pain management and rehabilitation strategy that keeps me awake at night, it’s pacing. Living with persistent pain, I loathe the idea of pacing because I know everyone “booms and busts” from time to time, and few people like the idea of planning every single aspect of every single day as they come to grips with modifying their daily routines. BUT it’s one of the most popular strategies in textbooks, self-help books, and in treatment so there must be something in it, right?
Vexed definitions
One of the problems with the whole pacing concept is defining what we mean by it. I...
Source: HealthSkills Weblog - April 28, 2019 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: 'Pacing' or Quota Chronic pain Clinical reasoning Coping Skills Coping strategies Occupational therapy Pain conditions Physiotherapy Research Science in practice activity management activity pacing pain management pain rehabilita Source Type: blogs
