233 posts · 239,921 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.
Adiemusfree
233 posts
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- November 17, 2011
- 01:53 AM
- 396 views
“Faking” pain – and inconsistency in presentation
by Adiemusfree 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
- November 14, 2011
- 01:24 PM
- 454 views
The vexed question of determining whether pain is “real”
by Adiemusfree in Healthskills: Skills for Healthy Living
Every now and then the old chestnut of whether it’s possible to determine if a person’s pain is “real” arises. Usually it’s in the form of an insurer, or maybe an employer, who wants to know if the pain this person is describing can possibly be as bad as the person says because “they don’t … 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
- October 16, 2011
- 02:15 PM
- 476 views
When patients think their problem is mysterious
by Adiemusfree in Healthskills: Skills for Healthy Living
This post is sparked off by a Facebook discussion where someone (you know who you are!) asked what to do when patients hold entrenched beliefs about the uniqueness or mysteriousness of their situation. They might say things like “I don’t think anyone know what to do with me”, or “I think because my situation is … Read more... Read more »
Ferreira, M., Machado, G., Latimer, J., Maher, C., Ferreira, P., & Smeets, R. (2010) Factors defining care-seeking in low back pain – A meta-analysis of population based surveys. European Journal of Pain, 14(7), 7470-2147483647. DOI: 10.1016/j.ejpain.2009.11.005
- September 26, 2011
- 05:00 PM
- 472 views
Empathy, distress and mindfulness
by Adiemusfree in Healthskills: Skills for Healthy Living
One of the main thrusts of the paper by Hadjistavropoulos, Craig, Duck, Cano, Goubert, Jackson, et al., is that pain communication can serve several functions – it can be an action where a message is sent or received; it can be an interaction where the message is sent, received and interpreted; or it can be … Read more... Read more »
Hadjistavropoulos, T., Craig, K., Duck, S., Cano, A., Goubert, L., Jackson, P., Mogil, J., Rainville, P., Sullivan, M., de C. Williams, A.... (2011) A biopsychosocial formulation of pain communication. Psychological Bulletin. DOI: 10.1037/a0023876
- September 19, 2011
- 03:29 PM
- 270 views
Seeing is believing?
by Adiemusfree in Healthskills: Skills for Healthy Living
I am slowly wending my way through a long, complex and incredibly important article by a group of researchers and clinicians writing about the social element of pain. The basic premise of this paper is that while pain is a private experience, we are social creatures. As social creatures, we communicate about things that are … Read more... Read more »
Hadjistavropoulos, T., Craig, K., Duck, S., Cano, A., Goubert, L., Jackson, P., Mogil, J., Rainville, P., Sullivan, M., de C. Williams, A.... (2011) A biopsychosocial formulation of pain communication. Psychological Bulletin. DOI: 10.1037/a0023876
- September 11, 2011
- 07:43 PM
- 428 views
Which comes first: Doing or knowing?
by Adiemusfree in Healthskills: Skills for Healthy Living
Received wisdom in cognitive behavioural therapy says that to change behaviour, a person must first change his or her thinking. This has created a tension between those clinicians who emphasise the cognitive aspects of pain management – and those who focus on helping people with pain do more. Should we educate and target cognitions, particularly … Read more... Read more »
Morley, S., & Keefe, F. (2007) Getting a handle on process and change in CBT for chronic pain. Pain, 127(3), 197-198. DOI: 10.1016/j.pain.2006.10.025
Morley, S. (2004) Process and change in cognitive behaviour therapy for chronic pain. Pain, 109(3), 205-206. DOI: 10.1016/j.pain.2004.02.008
- August 22, 2011
- 03:21 PM
- 945 views
Self management – a very vexing definition
by Adiemusfree in Healthskills: Skills for Healthy Living
Self management is one of those terms that is used to describe the aim of cognitive behavioural programmes for chronic pain. It’s even in my description of this blog! At the same time, it’s difficult to arrive at a definition of self management that “everyone” agrees upon. Self management can mean helping people to be “actively … Read more... Read more »
Wright, M., Wren, A., Somers, T., Goetz, M., Fras, A., Huh, B., Rogers, L., & Keefe, F. (2011) Pain Acceptance, Hope, and Optimism: Relationships to Pain and Adjustment in Patients With Chronic Musculoskeletal Pain. The Journal of Pain. DOI: 10.1016/j.jpain.2011.06.002
BLYTH, F., MARCH, L., NICHOLAS, M., & COUSINS, M. (2005) Self-management of chronic pain: a population-based study. Pain, 113(3), 285-292. DOI: 10.1016/j.pain.2004.12.004
Caiata Zufferey, M., & Schulz, P. (2009) Self-management of chronic low back pain: An exploration of the impact of a patient-centered website. Patient Education and Counseling, 77(1), 27-32. DOI: 10.1016/j.pec.2009.01.016
- August 17, 2011
- 03:35 PM
- 600 views
Education or a cognitive behavioural approach?
by Adiemusfree in Healthskills: Skills for Healthy Living
There is a reasonable amount of evidence suggesting that self management of chronic pain is only moderately effective. Some of the factors thought to influence outcomes include the “one size fits all” approach – people with chronic pain may not all equally benefit from the same aspects of a programme; that programmes are usually delivered … Read more... Read more »
Day, M., Thorn, B., & Kapoor, S. (2011) A Qualitative Analysis of a Randomized Controlled Trial Comparing a Cognitive-Behavioral Treatment With Education. The Journal of Pain. DOI: 10.1016/j.jpain.2011.02.354
Miles, C., Pincus, T., Carnes, D., Homer, K., Taylor, S., Bremner, S., Rahman, A., & Underwood, M. (2011) Can we identify how programmes aimed at promoting self-management in musculoskeletal pain work and who benefits? A systematic review of sub-group analysis within RCTs. European Journal of Pain. DOI: 10.1016/j.ejpain.2011.01.016
- August 11, 2011
- 04:17 PM
- 824 views
Not just neural plasticity – health system plasticity
by Adiemusfree in Healthskills: Skills for Healthy Living
In chronic pain management there seems to be a pretty consistent pathway for people to finally get to interdisciplinary treatment. First a referral from the primary care physician or GP to one or more specialist medical people – maybe an orthopaedic surgeon, or a rheumatologist, or a psychiatrist, or a neurologist. This person will carry … Read more... Read more »
Davies S, Quintner J, Parsons R, Parkitny L, Knight P, Forrester E, Roberts M, Graham C, Visser E, Antill T.... (2011) Preclinic group education sessions reduce waiting times and costs at public pain medicine units. Pain medicine (Malden, Mass.), 12(1), 59-71. PMID: 21087401
- August 9, 2011
- 03:16 PM
- 1,017 views
Low mood and catastrophising – one is bad, two is worse
by Adiemusfree in Healthskills: Skills for Healthy Living
Having pain that persists creates a lot of stress, but there are many people who can limit the effect on their life and carry on. These people seem to return to their everyday activities even if their pain hasn’t settled. Then there are the other people. This group have much more trouble managing with their … Read more... Read more »
Linton, S., Nicholas, M., MacDonald, S., Boersma, K., Bergbom, S., Maher, C., & Refshauge, K. (2011) The role of depression and catastrophizing in musculoskeletal pain. European Journal of Pain, 15(4), 416-422. DOI: 10.1016/j.ejpain.2010.08.009
- August 1, 2011
- 02:30 PM
- 861 views
More Managing Migraines without Medication
by Adiemusfree in Healthskills: Skills for Healthy Living
Anyone familiar with migraine will know the first signs of an impending attack. What might be a little less familiar is the precursor to the “first signs”, and what may also be unfamiliar is the thoughts that accompany those first symptoms. Today I want to talk about ways to manage this phase of a migraine … Read more... Read more »
Kelman L. (2004) The premonitory symptoms (prodrome): a tertiary care study of 893 migraineurs. Headache, 44(9), 865-72. PMID: 15447695
Thorn, B., Pence, L., Ward, L., Kilgo, G., Clements, K., Cross, T., Davis, A., & Tsui, P. (2007) A Randomized Clinical Trial of Targeted Cognitive Behavioral Treatment to Reduce Catastrophizing in Chronic Headache Sufferers. The Journal of Pain, 8(12), 938-949. DOI: 10.1016/j.jpain.2007.06.010
- July 25, 2011
- 09:42 PM
- 1,051 views
Managing Migraines without Medication
by Adiemusfree in Healthskills: Skills for Healthy Living
Ahhh, migraine – psychedelia without the high… nausea without the alcohol… The diagnostic criteria: A) At least 5 attacks fulfilling B-D; B) lasting untreated 4-74 hours; C) two of the following: unilateral, pulsating, moderate or severe pain intensity, worsening with physical activity; D) one of the following: nausea and/or vomiting, photophobia or phonophobia; E) not … Read more... Read more »
Grazzi, L., & Andrasik, F. (2010) Non-pharmacological approaches in migraine prophylaxis: behavioral medicine. Neurological Sciences, 31(S1), 133-135. DOI: 10.1007/s10072-010-0306-5
Grazzi, L., & Andrasik, F. (2010) Non-pharmacological approaches in migraine prophylaxis: part ii. Neurological Sciences, 31(S1), 137-139. DOI: 10.1007/s10072-010-0307-4
- July 24, 2011
- 03:15 PM
- 843 views
Using the Chronic Pain Acceptance Questionnaire
by Adiemusfree in Healthskills: Skills for Healthy Living
Over the past few months I’ve been using the Chronic Pain Acceptance Questionnaire (CPAQ-8) as part of a battery of questionnaires used at intake and outcome measures. Along with the CPAQ-8, we use the Tampa Scale for Kinesiophobia, the Depression Anxiety Stress Scale, the Pain Anxiety Symptoms Scale, the Pain Catastrophising Scale, Pain Self Efficacy … Read more... Read more »
Fish, R., McGuire, B., Hogan, M., Morrison, T., & Stewart, I. (2010) Validation of the Chronic Pain Acceptance Questionnaire (CPAQ) in an Internet sample and development and preliminary validation of the CPAQ-8. Pain, 149(3), 435-443. DOI: 10.1016/j.pain.2009.12.016
- July 17, 2011
- 03:30 PM
- 1,022 views
What matters: patient-determined outcomes and clinician/researcher outcomes
by Adiemusfree in Healthskills: Skills for Healthy Living
It’s easy to forget, sometimes, that when we choose an outcome measure, we need to seriously consider who will use the measures in the end. Of course, I am assuming that we’re all using outcome measures – we are, aren’t we? If anyone isn’t, shame on you – how on earth will you establish whether … Read more... Read more »
Beale, M., Cella, M., & de C. Williams, A. (2011) Comparing patients’ and clinician-researchers’ outcome choice for psychological treatment of chronic pain. PAIN. DOI: 10.1016/j.pain.2011.06.007
- July 11, 2011
- 03:29 PM
- 1,180 views
Self efficacy and fear of movement mediate pain intensity and disability in acute pain
by Adiemusfree in Healthskills: Skills for Healthy Living
Most clinicians working in chronic pain management are well aware that the time it takes for people to finally be referred for management of their pain is far too long and some of the readers of this blog who work with people who have acute pain may wonder whether anything I write about applies to … Read more... Read more »
Söderlund, A., & Åsenlöf, P. (2010) The mediating role of self-efficacy expectations and fear of movement and (re)injury beliefs in two samples of acute pain. Disability , 32(25), 2118-2126. DOI: 10.3109/09638288.2010.483036
- July 4, 2011
- 12:41 AM
- 1,281 views
“Oh wad some power the giftie gie us To see oursel’s as others see us! It wad frae monie a blunder free us, And foolish notion”
by Adiemusfree in Healthskills: Skills for Healthy Living
That quote from Robbie Burns. For such a long time it seems that pain research has focused only on the person having pain and less on the social context where the person is experiencing it. Pain is subjective, personal and private, and the only way I can determine whether someone is in pain is if … Read more... Read more »
Stomski, N., Mackintosh, S., & Stanley, M. (2010) Patient Self-report Measures of Chronic Pain Consultation Measures: A Systematic Review. Clinical Journal of Pain, 26(3). DOI: 10.1097/AJP.0b013e3181c84e76
- June 30, 2011
- 05:04 PM
- 1,078 views
What is this thing called pain?
by Adiemusfree in Healthskills: Skills for Healthy Living
As I’m busy writing up research papers for publications to “count” towards my research productivity, I’m reminded of one reason I keep on blogging – and it’s this: blogs are open to anyone. People can comment on what I write. When someone comments, whether they agree, disagree, or simply pose a question, it’s an opportunity … Read more... Read more »
Woolf, C. (2010) What is this thing called pain?. Journal of Clinical Investigation, 120(11), 3742-3744. DOI: 10.1172/JCI45178
- June 16, 2011
- 07:24 PM
- 919 views
What to do about catastrophising even when you’re not a psychologist
by Adiemusfree in Healthskills: Skills for Healthy Living
OK, it’s time I stopped the suspense. This post is about what to do about catastrophising even when you’re a physiotherapist, massage therapist, acupuncturist, nurse, occupational therapist, social worker – oh just about anyone working with people who have pain! Catastrophising is “an exaggerated negative “mental set” brought to bear during actual or anticipated pain … Read more... Read more »
Ciccone DS, Chandler HK, & Kline A. (2010) Catastrophic appraisal of acute and chronic pain in a population sample of new jersey national guard troops. The Clinical journal of pain, 26(8), 712-21. PMID: 20664336
- June 7, 2011
- 08:39 PM
- 1,017 views
A brief review of cognitive behavioural approaches for pain management
by Adiemusfree in Healthskills: Skills for Healthy Living
Cognitive behavioural approaches for pain management are not exactly the same as cognitive behavioural therapy for mental health problems. While there are some underlying concepts that are the same, cognitive behavioural approaches for pain management include a wider range of strategies, and are far less readily defined than the very structured approach used in mental … Read more... Read more »
Bailey, K. M., Carleton, R., Vlaeyen, J. W., & Asmundson, G. J. (2010) Treatments addressing pain-related fear and anxiety in patients with chronic musculoskeletal pain: A preliminary review. . Cognitive Behaviour Therapy, 39(1). DOI: 10.1080/16506070902980711
- June 2, 2011
- 04:26 AM
- 964 views
Catastrophising and Pain (ii)
by Adiemusfree in Healthskills: Skills for Healthy Living
What are some of the indications that someone tends to catastrophise about their pain? How do we know? Do we have to use a questionnaire? Is it really my job to know about this if I’m not a psychologist – and what do I do about it? These are the kinds of questions that have … Read more... Read more »
Ciccone DS, Chandler HK, & Kline A. (2010) Catastrophic appraisal of acute and chronic pain in a population sample of new jersey national guard troops. The Clinical journal of pain, 26(8), 712-21. PMID: 20664336
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