120 posts · 50,054 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
120 posts
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- March 14, 2010
- 02:20 PM
- 32 views
Maintaining change
by Adiemusfree in Healthskills: Skills for Healthy Living
I’m sure we’ve all seen it. The person comes into a pain management programme, gets excited, does really well during each session, enjoys the company and makes huge gains – then the programme ends and — FIZZLE! It all stops.
Some critics suggest that any change obtained during a short-term programme (such as a three-week [...]... Read more »
Christiansen, S., Oettingen, G., Dahme, B., & Klinger, R. (2010) A short goal-pursuit intervention to improve physical capacity: A randomized clinical trial in chronic back pain patients. Pain. DOI: 10.1016/j.pain.2009.12.015
- February 23, 2010
- 01:31 PM
- 78 views
Low back pain: unfit? just not doing much? or something else
by Adiemusfree in Healthskills: Skills for Healthy Living
For as long as I’ve been working in pain management (and probably well before), I’ve heard patients being described as ‘deconditioned’. From what we know about the effects of staying in bed because of illness or injury, it makes sense to think that if a person does very little they will become unfit. [...]... Read more »
Verbunt JA, Smeets RJ, & Wittink HM. (2010) Cause or effect? Deconditioning and chronic low back pain. Pain. PMID: 20153582
- February 22, 2010
- 01:36 PM
- 57 views
Bridging the self-management gap
by Adiemusfree in Healthskills: Skills for Healthy Living
Recently I ran an online survey on this blog asking the question ‘Should self management include:’ and then I listed a number of options such as ‘injection therapy’, ‘medications’, ‘intermittent hands-on therapy’, ‘intermittent hands-off therapy’ and so on. My thoughts were that while the term ’self-management’ is bandied about a lot, there isn’t really [...]... Read more »
Moore, A., & Jull, G. (2010) Capitalising on effective treatment strategies for low back pain – How do we bridge the self-management gap?. Manual Therapy, 15(2), 133-134. DOI: 10.1016/j.math.2010.01.007
- February 21, 2010
- 01:33 PM
- 57 views
People with high risk factors for disability get more biomedical information
by Adiemusfree in Healthskills: Skills for Healthy Living
For a couple of years now, the focus of researchers on factors that identify ‘high risk’ of ongoing disability has turned from patients and onto providers. I’ve written before that health provider’s own beliefs about pain, particularly pain-related anxiety and avoidance, can change the advice they give. This can lead to less ‘reassurance’ about [...]... Read more »
Shaw WS, Pransky G, Winters T, Tveito TH, Larson SM, & Roter DL. (2009) Does the presence of psychosocial "yellow flags" alter patient-provider communication for work-related, acute low back pain?. Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine, 51(9), 1032-40. PMID: 19687758
- February 17, 2010
- 01:25 PM
- 54 views
Do patients take their medications?
by Adiemusfree in Healthskills: Skills for Healthy Living
I don’t often write about medications, not because I don’t believe in their use but because that’s not my focus. However, just to put the record straight: medications and medical management of chronic pain has a place in the model of pain management I use. After all, it is the ‘bio-psychosocial’ model, not the psychosocial [...]... Read more »
Broekmans S, Dobbels F, Milisen K, Morlion B, & Vanderschueren S. (2010) Pharmacologic pain treatment in a multidisciplinary pain center: do patients adhere to the prescription of the physician?. The Clinical journal of pain, 26(2), 81-6. PMID: 20090432
- February 16, 2010
- 01:34 PM
- 61 views
Goals and satisfaction with pain management
by Adiemusfree in Healthskills: Skills for Healthy Living
I came across this paper by Rowland Hazard and colleagues amongst a whole lot of papers lying on my desk (those of you who’ve seen my desk will understand what a momentous occasion it was to find something there!). It describes a very useful finding from a study the group conducted on outcome measurement.
There [...]... Read more »
Hazard RG, Spratt KF, McDonough CM, Carayannopoulos AG, Olson CM, Reeves V, Sperry ML, & Ossen ES. (2009) The impact of personal functional goal achievement on patient satisfaction with progress one year following completion of a functional restoration program for chronic disabling spinal disorders. Spine, 34(25), 2797-802. PMID: 19910869
- February 15, 2010
- 01:37 PM
- 52 views
Here’s looking at us
by Adiemusfree in Healthskills: Skills for Healthy Living
For most of my clinical working life the focus in pain management has been on factors that identify people who have a high risk of developing long-term disability associated with their pain. The tide is turning, though, and increasingly we’re seeing papers published that look instead at treatment provider attitudes, beliefs and behaviours as [...]... Read more »
Bowey-Morris, J., Purcell-Jones, G., & Watson, P. (2010) Test-Retest Reliability of the Pain Attitudes and Beliefs Scale and Sensitivity to Change in a General Practitioner Population. The Clinical Journal of Pain, 26(2), 144-152. DOI: 10.1097/AJP.0b013e3181bada3d
- February 14, 2010
- 04:45 PM
- 76 views
How to judge a treatment
by Adiemusfree in Healthskills: Skills for Healthy Living
Last week I discussed an interview with F Sommer Anderson and also discussed aspects of central sensitisation syndromes, and Will Baum from where the client is kindly forwarded me a response by Dr Anderson. I am going to muse on one or two aspects of her response because they raise issues that I think are [...]... Read more »
Naik, A., Dyer, C., Kunik, M., & McCullough, L. (2009) Patient Autonomy for the Management of Chronic Conditions: A Two-Component Re-Conceptualization. The American Journal of Bioethics, 9(2), 23-30. DOI: 10.1080/15265160802654111
- February 10, 2010
- 02:45 AM
- 75 views
An interview with F Sommer Anderson – & central sensitisation syndromes
by Adiemusfree in Healthskills: Skills for Healthy Living
How many of you have headed off to ‘Therapy Worksheets’ blog? Yes, that’s the one I’ve linked to in my roundup of the best CBT resources on the internet. Will Baum, the editor of that blog is also the author of where the client is, a blog about professional private practice in mental health care. [...]... Read more »
YUNUS, M. (2007) Fibromyalgia and Overlapping Disorders: The Unifying Concept of Central Sensitivity Syndromes. Seminars in Arthritis and Rheumatism, 36(6), 339-356. DOI: 10.1016/j.semarthrit.2006.12.009
- February 9, 2010
- 01:46 PM
- 80 views
Balance, control & passion
by Adiemusfree in Healthskills: Skills for Healthy Living
Yesterday a couple of colleagues were talking about balance in life, and making it plain that they think people who spend a lot of time and energy on their work are sad. Their opinion? Work is the means to pay for your ‘real’ life, to spend more on working means less on what is really [...]... Read more »
MCCRACKEN, L., & VOWLES, K. (2007) Psychological Flexibility and Traditional Pain Management Strategies in Relation to Patient Functioning With Chronic Pain: An Examination of a Revised Instrument. The Journal of Pain, 8(9), 700-707. DOI: 10.1016/j.jpain.2007.04.008
GUTIERREZ, O., LUCIANO, C., RODRIGUEZ, M., & FINK, B. (2004) Comparison between an acceptance-based and a cognitive-control-based protocol for coping with pain*. Behavior Therapy, 35(4), 767-783. DOI: 10.1016/S0005-7894(04)80019-4
- February 8, 2010
- 01:32 PM
- 74 views
How do you establish who will do well with pain management?
by Adiemusfree in Healthskills: Skills for Healthy Living
Some people just won’t do well with pain management. In just the same way as a surgeon selects good candidates for surgery, so people need to be selected for self management. Although there is some truth that getting even a little pain management is good for everyone, the cost of doing so in staff energy [...]... Read more »
Foster, N., Thomas, E., Bishop, A., Dunn, K., & Main, C. (2009) Distinctiveness of psychological obstacles to recovery in low back pain patients in primary care. Pain. DOI: 10.1016/j.pain.2009.11.002
McCracken, L., & Zhao-O’Brien, J. (2010) General psychological acceptance and chronic pain: There is more to accept than the pain itself. European Journal of Pain, 14(2), 170-175. DOI: 10.1016/j.ejpain.2009.03.004
- February 7, 2010
- 01:41 PM
- 84 views
How long does it take to get there?
by Adiemusfree in Healthskills: Skills for Healthy Living
With so many people experiencing long term pain and disability, you’d think health care providers (and funders) would be doing all they could to make sure referrals to specialist centres were made as early as possible – and yet it’s still just not happening. I took a brief look through the referrals to our tertiary [...]... Read more »
Bonezzi, C., Pitino, E., & Allegri, M. (2009) Analysis of a population of patients who were referred to a second level pain center: Clinical and demographic characteristics. European Journal of Pain Supplements, 3(2), 17-20. DOI: 10.1016/j.eujps.2009.08.003
- February 2, 2010
- 01:33 PM
- 83 views
A wish list for a pain management programme
by Adiemusfree in Healthskills: Skills for Healthy Living
As I review the last few people I’ve had the privilege to assess, I can see numerous factors that have lead them down the road to chronic disability from their persistent pain. One of the most common would have to be multiple medical assessments with medical management that has failed to address the person’s disability, [...]... Read more »
Williams, A., & Potts, H. (2010) Group membership and staff turnover affect outcomes in group CBT for persistent pain. Pain. DOI: 10.1016/j.pain.2009.12.011
- January 18, 2010
- 02:41 PM
- 172 views
When in danger, when in doubt, just remember – deep breath in, deep breath out
by Adiemusfree in Healthskills: Skills for Healthy Living
It was a physio who first chanted that wee slogan at me some ten years ago… for a physio, he wasn’t bad at all! Come to think of it, I have worked with some great physiotherapists (please don’t let them know!). Anyway, it’s been one of those sayings that I’ve carried with me ever [...]... Read more »
Zautra, A., Fasman, R., Davis, M., & Craig, A. (2010) The effects of slow breathing on affective responses to pain stimuli: An experimental study. Pain. DOI: 10.1016/j.pain.2009.10.001
- January 17, 2010
- 04:34 PM
- 146 views
Depression, demoralisation and CBT for everyone
by Adiemusfree in Healthskills: Skills for Healthy Living
I was roving through my Twitter feed this morning,when I got word (via Gail Eva) of a paper debating the introduction of an enormous amount of money to provide CBT to people in England with anxiety and depression. The paper is in the British Journal of Psychiatry here and it’s available in its entirety.
While [...]... Read more »
Summerfield, D., & Veale, D. (2008) Proposals for massive expansion of psychological therapies would be counterproductive across society. The British Journal of Psychiatry, 192(5), 326-330. DOI: 10.1192/bjp.bp.107.046961
- January 13, 2010
- 02:36 PM
- 139 views
Do people use the same ways of coping over the lifetime of their pain?
by Adiemusfree in Healthskills: Skills for Healthy Living
This is a bit of an unanswered question – do people use the same coping strategies at the beginning of their experience with chronic pain, or are there shifts in coping as time goes on?
I’ve been pondering, as I do when writing my PhD, about the ways we have studied ‘coping’ in chronic pain. It’s [...]... Read more »
Van Damme, S., Crombez, G., & Eccleston, C. (2008) Coping with pain: A motivational perspective. Pain, 139(1), 1-4. DOI: 10.1016/j.pain.2008.07.022
- January 12, 2010
- 02:51 PM
- 116 views
Attention Please! Attention management for chronic pain
by Adiemusfree in Healthskills: Skills for Healthy Living
A debate that’s been going on for some time is the role of ‘distraction’ in pain management. So many of the people I see have told me they ‘just ignore’ the pain, or ‘I try to distract myself’, or similar, that there isn’t much doubt to me that people habitually use attention management as a [...]... Read more »
Elomaa, M., de C. Williams, A., & Kalso, E. (2009) Attention management as a treatment for chronic pain. European Journal of Pain, 13(10), 1062-1067. DOI: 10.1016/j.ejpain.2008.12.002
- January 11, 2010
- 03:30 PM
- 120 views
Two tools for screening risk: STarT Back Tool and Örebro Musculoskeletal Pain Screening Questionnaire
by Adiemusfree in Healthskills: Skills for Healthy Living
I wrote yesterday about the difficulty there is in grouping patients so that the right treatment is given to the right person at the right time. Today’s post coincidentally follows a similar line – two screening tools that discriminate between ‘high risk’ and ‘low risk’ people with low back pain. The value of [...]... Read more »
Hill, J., Dunn, K., Main, C., & Hay, E. (2010) Subgrouping low back pain: A comparison of the STarT Back Tool with the Örebro Musculoskeletal Pain Screening Questionnaire. European Journal of Pain, 14(1), 83-89. DOI: 10.1016/j.ejpain.2009.01.003
- January 10, 2010
- 05:41 PM
- 137 views
People with pain are not all alike: MPI classifications & outcome
by Adiemusfree in Healthskills: Skills for Healthy Living
As an individual with chronic pain, I know that each person with chronic pain is different from the next, and as a clinician I know that there are few ways to predict who will benefit from what treatment – but it’s like a Holy Grail to find a way to group together people who will [...]... Read more »
Martin L Verra, Felix Angst, Roberto Brioschi, Susanne Lehmann, Francis J Keefe, J Bart Staal, Rob A de Bie, André Aeschlimann. (2009) Does classification of persons with fibromyalgia into Multidimensional Pain Inventory subgroups detect differences in outcome after a standard chronic pain management program?. Pain Research , 14(6), 445. info:/1929024711
- December 20, 2009
- 08:01 PM
- 206 views
Getting through it
by Adiemusfree in Healthskills: Skills for Healthy Living
Some of you may know that I’ve just had surgery, and I’m gently recovering from the comfort of my own home over the next few weeks. Posts on here will be intermittent but I find myself considering aspects of pain management from a ‘patient’s’ perspective today as it’s about 5 days since surgery and my [...]... Read more »
Leegaard, M., Nåden, D., & Fagermoen, M. (2008) Postoperative pain and self-management: women’s experiences after cardiac surgery. Journal of Advanced Nursing, 63(5), 476-485. DOI: 10.1111/j.1365-2648.2008.04727.x
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