Patient rated outcome measures (PROM) in Chronic Pain

February 26, 2020 by Sian Smale

As our knowledge of chronic pain broadens, we are beginning to appreciate that there are modifiable risk factors that contribute to the development of long term pain and disability. Fear avoidance, negative beliefs, anxiety and depression are just a few. Several outcome measures are currently available to clinicians to help guide their clinical reasoning by identifying these risk factors. The purpose of this blog is to look specifically at outcome measures and explore how they guide our patient management.

Introducing the Imprecision Hypothesis in Chronic Pain

October 06, 2015 by Sian Smale

I'm so excited to share with you something I've recently come to learn about - the Imprecision Hypothesis in Chronic pain. A paper published in 2015 by Moseley & Vlaeyen explores associative learning and imprecise encoding of danger messages and provides insight into how these changes contribute to the development of chronic pain. It offers a different yet complementing hypothesis to that of central sensitisation in pain.

Deciphering the driving mechanisms in chronic low back pain

September 24, 2015 by Sian Smale

When it comes to discussing the diagnosis of low back pain (LBP) there are times when it is really hard to put a label on pain because it is hard to say is it one specific thing. Such a blurry diagnosis. In fact 85-90% of people with LBP are in this category making the blurry diagnosis the majority. The O'Sullivan system is a framework that aims to identify the main drivers and mechanisms of pain and dysfunction. Where movement is associated with pain, the classification considers if the movement is protective or maladaptive? This blog is all about this framework, breaking it down step by step, to help others see how using this classification system makes a complex pain disorder less complicated.

The bidirectional relationship between sleep disorders and pain conditions

September 15, 2015 by Sian Smale

The primary problem I treat as a Physiotherapist is pain. Despite the link between pain and sleep being extensively studied over the past few decades, I know little about what the research has found. What I've come to understand is that the bidirectional relationship between sleep and medical conditions such as cardiovascular disease also extends to pain disorders. I'm curious about how many people suffer from chronic pain conditions and concurrent sleep disorders? This blog looks more closely at what we currently know from research about sleep and pain.

Explaining central sensitisation to patients

January 09, 2015 by Sian Smale

Pain education in the clinical setting, particularly in a 1:1 setting with patients can be very challenging to do. The aim of this blog is to define the changes which occur within the body that result in central sensitisation and some options of how to educate patients about the meanings of chronic pain and central sensitisation pain.

Meet Marnie...Central Sensitisation Case Study

October 31, 2014 by Alicia Rayner

I had often read the theory of central sensitisation, told to look for signs of "central sensitisation" during my subjective and physical assessment. However, I had rarely seen a true "central sensitisation" patient...until I treated Marnie. This blog outlines her story, her clinical presentation, her descriptors of the condition, failed management and the management journey I undertook with her.