164 posts · 72,275 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
164 posts
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- August 31, 2010
- 03:35 PM
- 33 views
Measuring changes during graded exposure & acceptance treatment
by Adiemusfree in Healthskills: Skills for Healthy Living
I have been pondering about the best way to monitor ‘Matt’s progress during graded exposure therapy for his avoidance of activities involving back movement. I introduced you to Matt yesterday. He’s a ‘man’s man’, a real bloke who, for the past four years since he had surgery for a prolapsed disc, has avoided things like … Read more... Read more »
Wicksell, R., Lekander, M., Sorjonen, K., & Olsson, G. (2010) The Psychological Inflexibility in Pain Scale (PIPS) – Statistical properties and model fit of an instrument to assess change processes in pain related disability. European Journal of Pain, 14(7), 7710-2147483647. DOI: 10.1016/j.ejpain.2009.11.015
- August 29, 2010
- 03:33 PM
- 34 views
Exposure in vivo for kinesiophobia
by Adiemusfree in Healthskills: Skills for Healthy Living
Sometimes, even with the best practice, treatment doesn’t go the way you expect it to. Graded exposure, using a phobia treatment model, can be one of those amazingly quick methods – or it can be a long-haul challenge. This paper by Flink, Boersma and Linton, just published in European Journal of Pain identifies one of … Read more... Read more »
Flink, I., Boersma, K., & Linton, S. (2010) Catastrophizing moderates the effect of exposure in vivo for back pain patients with pain-related fear. European Journal of Pain, 14(8), 887-892. DOI: 10.1016/j.ejpain.2010.02.003
- August 24, 2010
- 11:05 PM
- 40 views
Drawing pain
by Adiemusfree in Healthskills: Skills for Healthy Living
The pain drawing has to be one of the more ubiquitous assessment tools around. There are many versions of outlines of naked bodies on which a person can scribble, colour, and write to indicate to treatment providers exactly where they feel their pain, and to a certain extent, some of the sensory features of that … Read more... Read more »
Schott, G. (2010) The cartography of pain: The evolving contribution of pain maps. European Journal of Pain, 14(8), 784-791. DOI: 10.1016/j.ejpain.2009.12.005
- August 23, 2010
- 03:35 PM
- 48 views
Information is to behaviour change as spaghetti is to a brick
by Adiemusfree in Healthskills: Skills for Healthy Living
I’m a great fan of books like ‘Explain Pain’. This delightful publication by David Butler and Lorimer Moseley gives accurate information about pain, particularly chronic pain, in an accessible format for both patients and clinicians, and I’ve used it often with people I’m seeing. I’m also a fan of helping people to understand what we … Read more... Read more »
Moseley, G. (2007) Reconceptualising pain according to modern pain science. Physical Therapy Reviews, 12(3), 169-178. DOI: 10.1179/108331907X223010
- August 23, 2010
- 05:14 AM
- 32 views
Who drops out of CBT for chronic pain?
by Adiemusfree in Healthskills: Skills for Healthy Living
Wouldn’t it be wonderful if everyone we saw was ready for self management and committed to putting everything in place? Wouldn’t it be even better if we could tell who was and who wasn’t going to drop out? Then we could focus treatment on people who were ready for treatment, and help those who are … Read more... Read more »
Glombiewski, J A, Hartwich-Tersek, J, & Rief,W. (2010) Attrition in Cognitive-behavioral Treatment of Chronic Back Pain. Clinical Journal of Pain, 26(7), 593-601. info:/
- August 17, 2010
- 03:36 PM
- 51 views
Exercise questions
by Adiemusfree in Healthskills: Skills for Healthy Living
If there is one finding that has remained pretty solid over the past 10 – 15 years, it’s the one that says being active is a good thing for managing chronic pain. I’m not sure how many papers I’ve read where ‘exercise’ and some form of cognitive behavioural approach have been found to produce improvements … Read more... Read more »
Pengel LH, Refshauge KM, Maher CG, Nicholas MK, Herbert RD, & McNair P. (2007) Physiotherapist-directed exercise, advice, or both for subacute low back pain: a randomized trial. Annals of internal medicine, 146(11), 787-96. PMID: 17548410
- August 15, 2010
- 08:03 PM
- 53 views
How well do we really communicate?
by Adiemusfree in Healthskills: Skills for Healthy Living
I’m pretty sure most clinicians want to believe that they treat people with equal respect, that they listen carefully and respond with empathy when a person has concerns about their health. At the same time I’ve listened to many people with chronic pain describe how they’ve had trouble feeling heard, how they can feel like … Read more... Read more »
Gulbrandsen, P., Madsen, H., Benth, J., & Lærum, E. (2010) Health care providers communicate less well with patients with chronic low back pain – A study of encounters at a back pain clinic in Denmark. Pain, 150(3), 458-461. DOI: 10.1016/j.pain.2010.05.024
- August 11, 2010
- 03:31 PM
- 58 views
What do people with chronic pain & health anxiety worry about?
by Adiemusfree in Healthskills: Skills for Healthy Living
While there is a whole heap of research going on in the area of chronic pain, something that seems to be missing at times is the experience of the person who has the pain. When I take a look through a journal I can see loads of articles with fabulous treatments and awesome brain scan … Read more... Read more »
Tang, N., Salkovskis, P., Hodges, A., Soong, E., Hanna, M., & Hester, J. (2009) Chronic pain syndrome associated with health anxiety: A qualitative thematic comparison between pain patients with high and low health anxiety. British Journal of Clinical Psychology, 48(1), 1-20. DOI: 10.1348/014466508X336167
- August 10, 2010
- 02:43 PM
- 66 views
Is reassurance reassuring?
by Adiemusfree in Healthskills: Skills for Healthy Living
Having started yesterday’s post by discussing health anxiety, and pointing out that one of the things people do to cope with their anxiety about their pain is to seek reassurance, I thought it might be useful to go back to a paper published a couple of years ago by Linton, McCracken & Vlaeyen (2008). In … Read more... Read more »
LINTON, S., MCCRACKEN, L., & VLAEYEN, J. (2008) Reassurance: Help or hinder in the treatment of pain. Pain, 134(1-2), 5-8. DOI: 10.1016/j.pain.2007.10.002
- August 9, 2010
- 03:20 PM
- 54 views
Does thinking keep it so? Health anxiety & memories
by Adiemusfree in Healthskills: Skills for Healthy Living
Years ago, the relationship between depression and chronic pain was the hot topic, and it’s only more recently that anxiety and pain have become popular. So slightly tangentially, but I think you’ll see how it relates, today I want to muse a bit about health anxiety and some of the findings from this interesting area … Read more... Read more »
Muse, K., McManus, F., Hackmann, A., Williams, M., & Williams, M. (2010) Intrusive imagery in severe health anxiety: Prevalence, nature and links with memories and maintenance cycles. Behaviour Research and Therapy, 48(8), 792-798. DOI: 10.1016/j.brat.2010.05.008
- August 8, 2010
- 03:41 PM
- 46 views
Top down, bottom up or both? Attention to pain
by Adiemusfree in Healthskills: Skills for Healthy Living
I guess we all pretty much know that our brains don’t seem to capture everything that goes on around us – thankfully we can filter out a lot of unnecessary information (no, I don’t want to know what that funny noise outside is right now!) so that we can focus on what is important. When … Read more... Read more »
Legrain V, Damme SV, Eccleston C, Davis KD, Seminowicz DA, & Crombez G. (2009) A neurocognitive model of attention to pain: behavioral and neuroimaging evidence. Pain, 144(3), 230-2. PMID: 19376654
- August 2, 2010
- 04:25 AM
- 56 views
Measuring the total impact of a health condition
by Adiemusfree in Healthskills: Skills for Healthy Living
When I think of the ‘cost’ of having a disability, I have to say I usually think about the effect of the disorder alone on the ability to do valued activities – I haven’t usually thought about the impact of the treatment itself on how people live their lives. I came across this paper by … Read more... Read more »
Devins, G. (2010) Using the Illness Intrusiveness Ratings Scale to understand health-related quality of life in chronic disease. Journal of Psychosomatic Research, 68(6), 591-602. DOI: 10.1016/j.jpsychores.2009.05.006
- July 28, 2010
- 03:29 PM
- 83 views
What do we do about placebo?
by Adiemusfree in Healthskills: Skills for Healthy Living
Body in Mind recently featured a piece on the ‘Moral Dilemma of Offering a Known Placebo’ in which Neil O’Connell talks about how the ‘placebo effect … in part rests on the effects of expectation, belief in the treatment and possibly a re-evaluation by the patient of their symptoms’. He was referring to treatments like … Read more... Read more »
Moerman DE. (2002) The meaning response and the ethics of avoiding placebos. Evaluation , 25(4), 399-409. PMID: 12449083
- July 26, 2010
- 03:44 PM
- 55 views
Assessment as intervention
by Adiemusfree in Healthskills: Skills for Healthy Living
When you start to put together all the elements that people want from a health interaction, it’s not surprising that simply having an assessment can be an incredibly powerful experience. So much so that an assessment can be counted as an intervention in its own right. Does that make you think about the investment you … Read more... Read more »
Poston, J., & Hanson, W. (2010) Meta-analysis of psychological assessment as a therapeutic intervention. Psychological Assessment, 22(2), 203-212. DOI: 10.1037/a0018679
- July 25, 2010
- 03:32 PM
- 55 views
Mindfulness and exercise?
by Adiemusfree in Healthskills: Skills for Healthy Living
Now I know this might seem a strange heading when we think of mindfulness practice normally, but this isn’t ‘treatment as usual’. The definition of mindfulness in this study is ‘The body scan practice involves systematically moving awareness through each part of the body and noticing the presence of sensation in a detailed and precise … Read more... Read more »
Cusens, B., Duggan, G., Thorne, K., & Burch, V. (2009) Evaluation of the breathworks mindfulness-based pain management programme: effects on well-being and multiple measures of mindfulness. Clinical Psychology . DOI: 10.1002/cpp.653
- July 21, 2010
- 07:17 AM
- 105 views
Accepting what life throws at ya
by Adiemusfree in Healthskills: Skills for Healthy Living
I was looking to write about a new treatment, or something that is innovative, and you know, there isn’t a whole lot new out there in pain management land. If it wasn’t for Lorimer Moseley’s work on motor imagery and Lance McCracken’s work on acceptance, I think we’d be doing pretty much what I was … Read more... Read more »
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
- July 20, 2010
- 01:53 AM
- 68 views
What do people really do about their back pain? An on-line survey reveals…
by Adiemusfree in Healthskills: Skills for Healthy Living
There are many studies describing the way treatment providers fail to follow clinical guidelines for managing acute low back pain – and because there are inconsistencies between various guidelines for chronic low back pain, it’s not surprising that people with back pain (whether acute or chronic) get a little confused about what to do. Of … Read more... Read more »
Wilk V, Palmer HD, Stosic RG, & McLachlan AJ. (2010) Evidence and practice in the self-management of low back pain: findings from an Australian internet-based survey. The Clinical journal of pain, 26(6), 533-40. PMID: 20551729
- July 20, 2010
- 01:53 AM
- 59 views
What do people really do about their back pain? An on-line survey reveals…
by Adiemusfree in Healthskills: Skills for Healthy Living
There are many studies describing the way treatment providers fail to follow clinical guidelines for managing acute low back pain – and because there are inconsistencies between various guidelines for chronic low back pain, it’s not surprising that people with back pain (whether acute or chronic) get a little confused about what to do. Of … Read more... Read more »
Wilk V, Palmer HD, Stosic RG, & McLachlan AJ. (2010) Evidence and practice in the self-management of low back pain: findings from an Australian internet-based survey. The Clinical journal of pain, 26(6), 533-40. PMID: 20551729
- July 20, 2010
- 01:53 AM
- 59 views
What do people really do about their back pain? An on-line survey reveals…
by Adiemusfree in Healthskills: Skills for Healthy Living
There are many studies describing the way treatment providers fail to follow clinical guidelines for managing acute low back pain – and because there are inconsistencies between various guidelines for chronic low back pain, it’s not surprising that people with back pain (whether acute or chronic) get a little confused about what to do. Of … Read more... Read more »
Wilk V, Palmer HD, Stosic RG, & McLachlan AJ. (2010) Evidence and practice in the self-management of low back pain: findings from an Australian internet-based survey. The Clinical journal of pain, 26(6), 533-40. PMID: 20551729
- July 18, 2010
- 03:29 PM
- 80 views
Intuition and other failings in clinical reasoning
by Adiemusfree in Healthskills: Skills for Healthy Living
Einstein is accredited with saying “The important thing is not to stop questioning” while Euripedes apparently said “Question everything. Learn something. Answer nothing.” I’m sure of the origins of neither quote – but I think I must have inhaled both of them when I was a toddler because I have never stopped asking ‘why’! In … Read more... Read more »
Croskerry, P. (2002) Achieving Quality in Clinical Decision Making: Cognitive Strategies and Detection of Bias. Academic Emergency Medicine, 9(11), 1184-1204. DOI: 10.1197/aemj.9.11.1184
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