233 posts · 240,439 views
Bronwyn Thompson is a pain management clinician and senior clinical lecturer in pain management. She writes from a biopsychosocial perspective, and primarily discusses psychosocial management of chronic pain.
Healthskills: Skills for Healthy Living
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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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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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