254 posts · 375,328 views
This blog offers health care providers thoughtful commentary and resources so they can help people develop their skills for living well, while respecting individual values. Much of the blog is concerned with the management of chronic pain.
Bronwyn Thompson
254 posts
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- January 24, 2016
- 02:45 PM
- 568 views
Treat the pain... or treat the depression? Carpal Tunnel Syndrome management
by Bronwyn Thompson in Healthskills: Skills for Healthy Living
Carpal tunnel syndrome is a very common pain disorder associated with compression of the median nerve at the carpal tunnel. Approximately 139 women and 67 males per 100,000 people will report this problem over the course of one year, although this depends on the definition used. The problem with CTS is not only that it is common, but also that it affects function - it is really difficult to carry out normal daily life with a numb or tingly hand, poor grip strength (particularly in the fingertips........ Read more »
Fernández-Muñoz, J., Palacios-Ceña, M., Cigarán-Méndez, M., Ortega-Santiago, R., de-la-Llave-Rincón, A., Salom-Moreno, J., & Fernández-de-las-Peñas, C. (2016) Pain is Associated to Clinical, Psychological, Physical, and Neurophysiological Variables in Women With Carpal Tunnel Syndrome. The Clinical Journal of Pain, 32(2), 122-129. DOI: 10.1097/AJP.0000000000000241
- December 6, 2015
- 03:17 PM
- 549 views
Fibro fog or losing your marbles: the effect of chronic pain on everyday executive functioning
by Bronwyn Thompson in Healthskills: Skills for Healthy Living
There are days when I think I’m losing the plot! When my memory fades, I get distracted by random thin—-ooh! is that a cat?!
We all have brain fades, but people with chronic pain have more of them. Sometimes it’s due to the side effects of medication, and often it’s due to poor sleep, or low mood – but whatever the cause, the problem is that people living with chronic pain can find it very hard to direct their attention to what’s important, or to shift thei........ Read more »
Baker, K., Gibson, S., Georgiou-Karistianis, N., Roth, R., & Giummarra, M. (2015) Everyday Executive Functioning in Chronic Pain. The Clinical Journal of Pain, 1. DOI: 10.1097/AJP.0000000000000313
- May 24, 2015
- 06:19 PM
- 626 views
When medication side effects get in the way of living life
by Bronwyn Thompson in Healthskills: Skills for Healthy Living
There are very few people living with chronic pain who gleefully swallow a handful of pills and skip happily off for the day feeling chipper and bright as a button. For the most part, people living with chronic pain don’t seem to enjoy the need to take medications – I’ve heard some say they’re worried about “not being able to tell whether I’m doing damage” when they can’t feel their pain, others say they don’t think medications are very helpf........ Read more »
Martel MO, Finan PH, Dolman AJ, Subramanian S, Edwards RR, Wasan AD, & Jamison RN. (2015) Self-reports of medication side effects and pain-related activity interference in patients with chronic pain: a longitudinal cohort study. Pain, 156(6), 1092-100. PMID: 25782367
- April 19, 2015
- 05:29 PM
- 827 views
Accepting pain – or are we measuring something else?
by Bronwyn Thompson in Healthskills: Skills for Healthy Living
Acceptance is defined in Acceptance and Commitment Therapy (ACT) as “a willingness to remain in contact with and to actively experience particular private experiences (Hayes, Jacobson, Follette, Dougher, 1994) (eds): Acceptance and Change: Content and Context in Psychotherapy. Reno, Context Press, 1994), and from this Lance McCracken and colleagues developed the Chronic Pain Acceptance Questionnaire. This measure has two dimensions: willingness to experience pain and engaging in values-dir........ Read more »
Lauwerier, E., Caes, L., Van Damme, S., Goubert, L., Rosseel, Y., & Crombez, G. (2015) Acceptance: What's in a Name? A Content Analysis of Acceptance Instruments in Individuals With Chronic Pain. The Journal of Pain, 16(4), 306-317. DOI: 10.1016/j.jpain.2015.01.001
- October 19, 2014
- 06:39 PM
- 742 views
Pain is not a "Thing"
by Bronwyn Thompson in Healthskills: Skills for Healthy Living
ResearchBlogging.org
I’m reading some fascinating books at the moment. I’m such a pain geek I take pain books away with me on holiday! Anyway, the two books to hit me between the eyeballs recently are The Pain Chronicles by Melanie Thernstrom (published 2010), and The Story of Pain by Joanna Bourke (published 2014). What makes both of these books fascinating is that these both look at the history of pain and pain management, and explore the “what it is like” to be in pai........ Read more »
Ashton-James, C., Richardson, D., Williams, A., Bianchi-Berthouze, N., & Dekker, P. (2014) Impact of pain behaviors on evaluations of warmth and competence. PAIN®. DOI: 10.1016/j.pain.2014.09.031
- October 12, 2014
- 03:48 PM
- 709 views
…but I thought a new knee would fix my pain!
by Bronwyn Thompson in Healthskills: Skills for Healthy Living
Working in an orthopaedic surgery department is quite enlightening. Along with discussions about ceramic vs metal implants and cartilage regeneration (I work with a team of researchers looking at how to create replacement cartilage), the topic of what counts as a surgical success in knee surgery also comes up from time to time. Knee joint replacement isn’t as successful as hip joint replacement for a number of reasons including the complex nature of the joint, the way the joint capsule is ........ Read more »
Fuzier, R., Serres, I., Bourrel, R., Palmaro, A., Montastruc, J., & Lapeyre-Mestre, M. (2014) Analgesic drug consumption increases after knee arthroplasty: A pharmacoepidemiological study investigating postoperative pain. PAIN®, 155(7), 1339-1345. DOI: 10.1016/j.pain.2014.04.010
- October 5, 2014
- 04:00 AM
- 689 views
I’m so easily distr….oooh look! Shiny!
by Bronwyn Thompson in Healthskills: Skills for Healthy Living
Wouldn’t it be great if there was a simple way to help people avoid focusing on their pain, allowing them to just watch a TV programme or something, and not be bothered by some painful procedure? This is a dream for those health professionals who have to carry out painful procedures like take blood, drill teeth, change dressings, stretch body parts and so on. It’s also an area of great interest for researchers, because studying how distraction affects our experience of pain shows us ........ Read more »
Schreiber, K., Campbell, C., Martel, M., Greenbaum, S., Wasan, A., Borsook, D., Jamison, R., & Edwards, R. (2014) Distraction Analgesia in Chronic Pain Patients. Anesthesiology, 1. DOI: 10.1097/ALN.0000000000000465
- September 28, 2014
- 12:00 PM
- 707 views
Numbers on a scale: How bad did you say your pain was?
by Bronwyn Thompson in Healthskills: Skills for Healthy Living
Have you ever been asked to give your pain rating on a scale of 0 – 10 (where 0 = no pain at all and 10 = most extreme pain you can imagine)? Have you ever tried to work out whether today’s pain is worse than yesterdays? What does a pain rating tell us?... Read more »
Anne M. Boonstra, Henrica R. Schiphorst Preuper, Gerlof A. Balk, & Roy E.Stewart. (2014) Cut-off points for mild, moderate and severe pain on the VAS for pain for patients with chronic musculoskeletal pain. Pain. DOI: http://dx.org/10.1016/j.pain.2014.09.014
- September 8, 2014
- 04:40 PM
- 718 views
“If I do that, I’ll be in more pain and won’t sleep and …” Tampa Scale of Kinesiophobia reformulated
by Bronwyn Thompson in Healthskills: Skills for Healthy Living
The TSK has been used for many years now as a good measure of kinesiophobia. Usually scores of above 45 (from a possible 68) suggest that the person has beliefs that their pain represents ongoing damage (Somatic focus) and that they should avoid doing anything that provokes pain (Activity avoidance). High scores have been associated with a wide range of negative outcomes including pain intensity, disability, distress – and in a wide range of individuals including people with chronic low b........ Read more »
Bunzli, S., Smith, A., Watkins, R., Schütze, R., & O’Sullivan, P. (2014) “What Do People who Score Highly on the Tampa Scale of Kinesiophobia Really Believe? A Mixed Methods Investigation in People with Chronic Non Specific Low Back Pain. The Clinical Journal of Pain, 1. DOI: 10.1097/AJP.0000000000000143
- August 24, 2014
- 04:51 PM
- 762 views
How does chronic pain management work? A hypothesis to ponder
by Bronwyn Thompson in Healthskills: Skills for Healthy Living
What DOES change in chronic pain management is people's self efficacy or belief that they CAN do what's important in their lives - by hook or by crook. And even more importantly, they have something to DO that's important to them. Maybe something that hasn't been studied in sufficient detail is what a person wants to be able to do, what's their motivation, what are their valued occupations? That's a hypothesis about therapeutic change I think we need to ponder.... Read more »
Burns, J., Nielson, W., Jensen, M., Heapy, A., Czlapinski, R., & Kerns, R. (2014) Does Change Occur for the Reasons We Think It Does? A Test of Specific Therapeutic Operations During Cognitive-Behavioral Treatment of Chronic Pain. The Clinical Journal of Pain, 1. DOI: 10.1097/ajp.0000000000000141
- June 8, 2014
- 06:11 PM
- 779 views
Discussions in chronic pain management
by Bronwyn Thompson in Healthskills: Skills for Healthy Living
Amongst the arguments around interdisciplinary programmes are discussions about how long or intense a programme should be (the “dose”), the content and what is or isn’t necessary within them, and personnel or who should or shouldn’t be involved. I thought I’d take a little look at some of these arguments.... Read more »
Broderick, J., Keefe, F., Bruckenthal, P., Junghaenel, D., Schneider, S., Schwartz, J., Kaell, A., Caldwell, D., McKee, D., Reed, S.... (2014) Nurse Practitioners can effectively deliver Pain Coping Skills Training to osteoarthritis patients with chronic pain: A randomized, controlled trial. PAIN®. DOI: 10.1016/j.pain.2014.05.024
Kaiser, U., Deckert, S., Kopkow, C., Schmitt, J., & Sabatowski, R. (2014) Dose or content? Effectiveness of pain rehabilitation programs for patients with chronic low back pain: a systematic review. Waterschoot et al., Pain 155 (2014) 179-189. PAIN®. DOI: 10.1016/j.pain.2014.06.002
Waterschoot, F., Dijkstra, P., Hollak, N., de Vries, H., Geertzen, J., & Reneman, M. (2014) Dose or content? Effectiveness of pain rehabilitation programs for patients with chronic low back pain: A systematic review. PAIN®, 155(1), 179-189. DOI: 10.1016/j.pain.2013.10.006
- April 27, 2014
- 06:25 PM
- 1,186 views
Important questions about service delivery in chronic pain management
by Bronwyn Thompson in Healthskills: Skills for Healthy Living
In all the time I’ve worked in health, two things have always been certain: there is never enough funding to deliver all the services to everyone who needs them, and there is never a shortage of patients. Never.
It’s time to ask some important questions about how and why we deliver the services we do for people who have chronic pain.... Read more »
Ehde, D., Dillworth, T., & Turner, J. (2014) Cognitive-behavioral therapy for individuals with chronic pain: Efficacy, innovations, and directions for research. American Psychologist, 69(2), 153-166. DOI: 10.1037/a0035747
- April 1, 2014
- 04:01 PM
- 935 views
Exercise and chronic pain
by Bronwyn Thompson in Healthskills: Skills for Healthy Living
While the overall premise of exercise is clear, the details of how often, what kind and the best approach for recovery after exercising are rather less. The problem for people with chronic pain is that moving HURTS. Some people have even argued that chronic pain is, in essence, an activity intolerance disorder... Read more »
Daenen, L., Varkey, E., Kellmann, M., & Nijs, J. (2014) Exercise, not to Exercise or how to Exercise in Patients with Chronic Pain? Applying Science to Practice. The Clinical Journal of Pain, 1. DOI: 10.1097/AJP.0000000000000099
- March 23, 2014
- 11:58 PM
- 942 views
Non-drug approaches for people with fibromyalgia
by Bronwyn Thompson in Healthskills: Skills for Healthy Living
No-one wants to be told their pain is “in your head”. But given our increasingly sophisticated understanding of pain neurobiology, there’s plenty of reason to agree that thinking, feeling and doing things differently makes life far more rewarding and rich than feeling helpless, fatigued and sore. Some proponents of purely biomedical interventions, notably musculoskeletal physicians, argue that if only the “source of the nociception” was found, the nerve “zappe........ Read more »
Luciano, J., Guallar, J., Aguado, J., López-del-Hoyo, Y., Olivan, B., Magallón, R., Alda, M., Serrano-Blanco, A., Gili, M., & Garcia-Campayo, J. (2014) Effectiveness of group acceptance and commitment therapy for fibromyalgia: A 6-month randomized controlled trial (EFFIGACT study). PAIN®, 155(4), 693-702. DOI: 10.1016/j.pain.2013.12.029
BERNARDY, K., FUBER, N., KOLLNER, V., & HAUSER, W. (2010) Efficacy of Cognitive-Behavioral Therapies in Fibromyalgia Syndrome -- A Systematic Review and Metaanalysis of Randomized Controlled Trials. The Journal of Rheumatology, 37(10), 1991-2005. DOI: 10.3899/jrheum.100104
Williams ACDC,, Eccleston C,, & Morley S. (2012) Psychological therapies for the management of chronic pain (excluding headache)in adults. Cochrane Database of Systematic Reviews. DOI: 10.1002/14651858.CD007407.pub3
- February 23, 2014
- 04:35 PM
- 876 views
Don't worry, be happy: Could optimism counteract the negative effects of pain?
by Bronwyn Thompson in Healthskills: Skills for Healthy Living
These researchers investigated whether optimism might (a) be able to be induced in people who are currently experiencing pain, and (b) might be able to reduce some of the fatiguing effects of self-regulation depletion. This is based on the notion that people who remain optimistic keep persisting with tasks even when the going is tough. They also investigated whether experimental pain has a direct effect on self-regulation (well, actually, executive task performance which is in turn affected by s........ Read more »
Jantine J.L.M. Boselie, Linda M.G. Vancleef, Tom Smeets, Madelon L. Peters. (2014) Increasing optimism abolishes pain-induced impairments in executive task performance. Pain, 155(2), 334. DOI: 10.1016/j.pain.2013.10.014
- February 23, 2014
- 04:35 PM
- 837 views
Don't worry, be happy: Could optimism counteract the negative effects of pain?
by Bronwyn Thompson in Healthskills: Skills for Healthy Living
These researchers investigated whether optimism might (a) be able to be induced in people who are currently experiencing pain, and (b) might be able to reduce some of the fatiguing effects of self-regulation depletion. This is based on the notion that people who remain optimistic keep persisting with tasks even when the going is tough. They also investigated whether experimental pain has a direct effect on self-regulation (well, actually, executive task performance which is in turn affected by s........ Read more »
Jantine J.L.M. Boselie, Linda M.G. Vancleef, Tom Smeets, Madelon L. Peters. (2014) Increasing optimism abolishes pain-induced impairments in executive task performance. Pain, 155(2), 334. DOI: 10.1016/j.pain.2013.10.014
- January 6, 2014
- 04:27 PM
- 915 views
Coping: neither good, nor bad, but “it depends”
by Bronwyn Thompson in Healthskills: Skills for Healthy Living
Coping is a concept we often use in chronic pain management. Our aim as clinicians is to help people with chronic pain cope with their pain so they can do more of what is important to them. Most of us know that coping mediates between the individual and whatever challenge he or she is facing. … Read more... Read more »
Biglan, Anthony, & Hayes, Steven C. (1996) Should the behavioral sciences become more pragmatic? The case for functional contextualism in research on human behavior. Applied , 5(1), 47-57. DOI: 10.1016/S0962-1849(96)80026-6
- May 15, 2012
- 08:21 PM
- 890 views
Trust, teamwork and transparency
by Bronwyn Thompson in Healthskills: Skills for Healthy Living
Teams are a feature of healthcare, and nowhere more so than in pain management. This is because, at least for chronic pain, no single profession can claim to have all the answers. Many of us know we need to rely on one another to address patient/client concerns and to provide a consistent approach for the … Read more... Read more »
Weaver R, Peters K, Koch J, & Wilson I. (2011) 'Part of the team': professional identity and social exclusivity in medical students. Medical education, 45(12), 1220-9. PMID: 21999250
- May 10, 2012
- 05:05 PM
- 876 views
Living well with persistent pain – a problem solving model
by Bronwyn Thompson in Healthskills: Skills for Healthy Living
Chronic pain is abnormal. Living well with chronic pain seems a myth, a bit of an impossibility. After all, chronic pain starts with the kind of pain that most people would expect to go away - acute pain. Acute pain is normal and most of us will experience some painful episode today. Acute pain goes … Read more... Read more »
Eccleston, C., & Crombez, G. (2007) Worry and chronic pain: A misdirected problem solving model. PAIN, 132(3), 233-236. DOI: 10.1016/j.pain.2007.09.014
Eccleston, C. (2011) A normal psychology of chronic pain. The Psychologist, 24(6), 422-425. info:/
- November 17, 2011
- 01:53 AM
- 1,580 views
“Faking” pain – and inconsistency in presentation
by Bronwyn Thompson in Healthskills: Skills for Healthy Living
There is a common belief amongst some people involved in pain and pain management that a person with chronic pain should be consistent in their presentation. That is, be consistent in various settings, and consistent across various measures. This assumes that if inconsistencies are present there must be something going on to cause suspicion about … Read more... Read more »
Gatchel, R., Kishino, N., & Minotti, D. (2010) The Three Major Components of Behavior Used for Assessing Pain: Problems Faced When There Is Discordance Among the Three. Psychological Injury and Law, 3(3), 212-219. DOI: 10.1007/s12207-010-9081-0
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