Pain Science and Sensibility

053 Is Therapeutic Alliance a Bust? Oct 27, 2021

Sandy and Cory discuss a recent paper that did not find an effect of providing education with therapeutic alliance in a chronic low back pain population. Does that settle the question of whether establishing a therapeutic alliance is worthwhile, or is there more to it? Of course there's more to it. Listen in on the conversation and see if you agree with our take.

Education With Therapeutic Alliance Did Not Improve Symptoms in Patients With Chronic Low Back Pain and Low Risk of Poor Prognosis Compared to Education Without Therapeutic Alliance: A Randomized Controlled Trial. Miyamoto GC, Fagundes FRC, de Melo do Espírito Santo C, et al. JOSPT. 2021 Aug;51(8):392-400. doi: 10.2519/jospt.2021.9636. Epub 2021 May 7.

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052 Beyond the BPS Model? Feb 27, 2021

In this episode, Sandy and Cory take a look at this popular publication from 2019 proposing an "Enactive Approach" to pain. There's a lot to cover in this paper as it takes us through a history of pain science up to the Biopsychosocial model at which point it proceeds to point out some flaws in the model. GASP! Take a listen as the discussion unfolds.

An enactive approach to pain: beyond the biopsychosocial model. Peter Stilwell & Katherine Harman. Phenomenology and the Cognitive Sciences. 18, pages637–665(2019). doi: 10.1007/s11097-019-09624-7.

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2020 PT Podcast Network Holiday Extravaganza Dec 14, 2020

The gang is all here (except Greg) for another festive dump of holiday cheer! Happy Holidays everyone!!!

050 Pain Flare-Up Nov 16, 2020

Pain flare-ups are one of the most frustrating things for patients and clinicians alike. Are they normal? Who gets them? Why is it important to know their prevalence? What are Sandy and Cory's thoughts on dealing with them? All this and more in episode 50!

Prevalence, Severity, and Correlates of Pain Flares in Response to a Repeated Sit-to-Stand Activity: A Cross-sectional Study of 14 902 Patients With Knee and Hip Osteoarthritis in Primary Care. Søren T Skou, Dorte T Grønne, Ewa M Roos. J Orthop Sports Phys Ther. 2020 Jun;50(6):309-318. doi: 10.2519/jospt.2019.9125. Epub 2019 Sep 6.

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049 Contemplating Possibilities and the Impermanence of Pain Aug 25, 2020

We are joined in this episode by Professor Lorimer Moseley AO for a casual chat about pain. Lorimer gave us his thoughts on recent and future clinical research and the translation of the evidence into the clinic. Is there an expiration date for recovery from persistent pain? How can we enhance learning the things that matter? Was it a mistake to think that we could/should explain pain? Does Sandy work pelvic health examples into this conversation?

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048 The SI Joint Narrative Jun 27, 2020

Do you use SI joint tests? What type of information do the tests give you? Should you be using them? These are just a few of the questions that arise in the discussion of this recent perspective paper. Join us for episode 48!

Changing the Narrative in Diagnosis and Management of Pain in the Sacroiliac Joint Area. Palsson TS, Gibson W, Darlow B, et al. Phys Ther. 2019;99(11):1511-1519. doi:10.1093/ptj/pzz108

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

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047 Is It Safe For Women To Lift Heavy Things? May 08, 2020

Is it safe to exercise and lift heavy things for people with pelvic organ prolapse symptoms? Or put more bluntly, will lifting heavy weights make your lady bits fall out? Is lifting weight asking for trouble? That is the question that our guest this month is seeking to answer and Sandy and Cory sit down to ask some questions about her recently published cross sectional study that is a start to this research. There are some important implications of this and potentially some misconceptions that are driving current approaches. Please listen as we are joined by physiotherapist and PhD candidate, Lori Forner for this episode of Pain Science and Sensibility.

Symptoms of pelvic organ prolapse in women who lift heavy weights for exercise: a cross-sectional survey. Forner LB, Beckman EM, Smith MD. Int Urogynecol J. 2019 Dec 7. doi: 10.1007/s00192-019-04163-w. [Epub ahead of print]

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

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046 Is There an Advantage to Pain Free Rehab? Mar 13, 2020

These questions arise very frequently in rehabilitation. Should it hurt? Is it OK if it hurts? Will I set myself back if it hurts? Will I get better if it doesn't hurt? In this episode we examine a pair of articles that examine these questions. One article is an RCT that covers pain free vs. painful exercise in an acutely injured population, while the other is a systematic review and meta analysis of the approach in chronic pain populations.

Pain-Free Versus Pain-Threshold Rehabilitation Following Acute Hamstring Strain Injury: A Randomized Controlled Trial. Hickey JT, Timmins RG, Maniar N, Rio E, Hickey PF, Pitcher CA, Williams MD, Opar DA. J Orthop Sports Phys Ther. 2020 Feb;50(2):91-103. doi: 10.2519/jospt.2020.8895.

Should exercises be painful in the management of chronic musculoskeletal pain? A systematic review and meta-analysis. Smith BE, Hendrick P, Smith TO, Bateman M, Moffatt F, Rathleff MS, Selfe J, Logan P. Br J Sports Med. 2017 Dec;51(23):1679-1687. doi: 10.1136/bjsports-2016-097383. Epub 2017 Jun 8.

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

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045 A Review of Surgery for Rotator Cuff Tears Jan 27, 2020

A recent Cochrane review looked at studies of people with rotator cuff tears comparing those who had surgery with those who did not. What do you think they found? Did surgery provide benefit? Is it OK to go without surgery in these cases? Sandy and Cory discuss these findings and provide their clinical commentary in this episode of Pain Science and Sensibility.

Surgery for rotator cuff tears. Karjalainen TV, Jain NB, Heikkinen J, Johnston RV, Page CM, Buchbinder R. Cochrane Database Syst Rev. 2019 Dec 9;12:CD013502. doi: 10.1002/14651858.CD013502.

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

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044 Cognitive Functional Therapy Vs. Group Therapy Plus Education Nov 20, 2019

This episode covers a recent paper that compares a popular and trending approach, Cognitive Functional Therapy, against a group treatment and exercise intervention. The primary outcomes were pain and disability. The results may surprise you. Join Sandy and Cory as they discuss the findings, what to make of them, and the clinical impact.

Cognitive functional therapy compared with a group-based exercise and education intervention for chronic low back pain: a multicentre randomised controlled trial (RCT). O'Keeffe M, O'Sullivan P, Purtill H, Bargary N, O'Sullivan K. Br J Sports Med. 2019 Oct 19. pii: bjsports-2019-100780. doi: 10.1136/bjsports-2019-100780. [Epub ahead of print]

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

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043 An Interview with Dr Henrik Vaegter Oct 09, 2019

In the last episode (42) a systematic review was discussed regarding the value of pre-operative measures in predicting pain post-operatively. In this episode, Dr. Henrik Vaegter, an author of that review joins us to discuss that research as well as several other fascinating topics regarding exercise and pain. In this interview we discuss topics of Exercise Induced Hypoalgesia, Conditioned Pain Modulation, and Temporal Summation of Pain, all of which are among the focus of Dr. Vaegter's research. What do the findings in these phenomenon tell us about how we should or should not address exercise in our patients with pain? Tune it to episode 43 for a very informative discussion!

Are preoperative experimental pain assessments correlated with clinical pain outcomes after surgery? A systematic review. Sangesland A, Støren C, Vaegter HB. Scand J Pain. 2017 Apr;15:44-52. doi: 10.1016/j.sjpain.2016.12.002. Epub 2016 Dec 19.

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

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042 Does Preop Pain Predict Postop Pain? Aug 30, 2019

In this episode Sandy and Cory discuss a systematic review which investigated what pre operative pain tells us about a person’s propensity for post operative pain. Is it predictive? If so, would changing it matter? The discussion gets into these topics and more.

Are preoperative experimental pain assessments correlated with clinical pain outcomes after surgery? A systematic review. Sangesland A, Støren C, Vaegter HB. Scand J Pain. 2017 Apr;15:44-52. doi: 10.1016/j.sjpain.2016.12.002. Epub 2016 Dec 19.

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

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041 Bedtimes and Pain: Can You Sleep It Off? Jun 12, 2019

This study looked at pain score associations between people with "typical" and "atypical" bedtimes. Sandy and Cory discuss the topic of sleep and pain broadly as well. So, perk up and see if you can make through this episode without dozing off.

Does bedtime matter among patients with chronic pain? A longitudinal comparison study. McHugh RK, Edwards R, Ross E, Jamison R. PAIN Reports. May/June 2019 - Volume 4 - Issue 3 - p e747. doi: 10.1097/PR9.0000000000000747.

We also discussed this paper: Effects of sleep changes on pain-related health outcomes in the general population: A systematic review of longitudinal studies with exploratory meta-analysis. Afolalu EF, Ramlee F, Tang NKY. Sleep Med Rev. 2018 Jun;39:82-97. doi: 10.1016/j.smrv.2017.08.001. Epub 2017 Aug 18.

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

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040 Does Activity Counteract Sitting? May 13, 2019

In this month's episode we are examining more of a general health question. But it is one that is very relevant to people in pain. Much has been made of "Sitting is the new smoking" with some indications that the negative effects of sitting may not be able to be undone with exercise and activity. This study looked at that concept in particular. Join us for Episode 40.

Sitting Time, Physical Activity, and Risk of Mortality in Adults. Stamatakis E, Gale J, Bauman A, Ekelund U, Hamer M, Ding D. J Am Coll Cardiol. 2019 Apr 30;73(16):2062-2072. doi: 10.1016/j.jacc.2019.02.031.

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

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039 Pain Education in Low Back Pain Apr 01, 2019

This paper, with results that many find very surprising, has started a bit of a buzz in the PT world. What do we make of the results? Can we trust the results? What does this mean in clinical practice? We were able to discuss these topics and more with the researchers themselves as Adrian Traeger and James McAuley were kind enough to share their time and help us navigate these new findings. Don't miss this episode!

Effect of Intensive Patient Education vs Placebo Patient Education on Outcomes in Patients With Acute Low Back Pain: A Randomized Clinical Trial. Traeger AC, Lee H, Hübscher M, Skinner IW, Moseley GL, Nicholas MK, Henschke N, Refshauge KM, Blyth FM, Main CJ, Hush JM, Lo S, McAuley JH. JAMA Neurol. 2018 Nov 5. doi: 10.1001/jamaneurol.2018.3376. [Epub ahead of print]

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

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038 Living Well with Chronic Pain Feb 09, 2019

Research on chronic pain tends to aim at identifying factors that are in deficit, or are the so called "risk factors" for those who develops chronic pain. In this episode, we discuss a paper that takes a different angle in looking at what factors do those people who are successfully living well with chronic pain share. The primary author is friend of the show, Bronnie Thompson, who has made guest appearances in previous episodes.

Living well with chronic pain: a classical grounded theory. Lennox Thompson B, Gage J, Kirk R. Disabil Rehabil. 2019 Jan 11:1-12. doi: 10.1080/09638288.2018.1517195. [Epub ahead of print]

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

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2018 PT Podcast Network Holiday Extravaganza Dec 11, 2018

That's right everyone! It's that time of year again! All the PT Podcast Network voices (except for Adam) have gathered together to bring you some podcast holiday cheer!

This very special episode is brought to you by My PT Insurance. Head on over to their website at myptins.com/ptinquest to be entered into a drawing for a $250 Amazon gift card (contest ends February 28, 2019). While you are there listeners can get a $20 discount off their already low price for a professional liability policy - starting as low as $149! Click the link for more info!

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037 Brain Representations of Expectancy Violation Nov 14, 2018

This episode covers a recent meta analysis looking at differences in brain patterns when an expectancy violation, thought to be important in effectiveness of exposure based therapies (see episodes 12, 15, and 31), occurs passively versus actively. Active expectancy violation is thought to be more likely to bring about a change in behavior. This research looked to see if there was a difference that could be identified in activated brain areas between the 2 conditions.

Learning about Expectation Violation from Prediction Error Paradigms – A Meta-Analysis on Brain Processes Following a Prediction Error. D’Astolfo L and Rief W. Front Psychol. 2017; 8: 1253. Published online 2017 Jul 28. doi: [10.3389/fpsyg.2017.01253]

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

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036 Mechanism Based Pain Care Sep 28, 2018

In this episode, Sandy and Cory discuss a recent paper proposing a "Mechanism Based approach to physical therapy management of pain." This paper proposes 5 mechanisms to consider when managing people in pain and how some common PT interventions may impact these mechanisms. The discussion goes into some of the details of these proposals as well as some of the criticisms that have been generated with regards to the paper.

A Mechanism-Based Approach to Physical Therapist Management of Pain. Chimenti RL, Frey-Law LA, Sluka KA. Phys Ther. 2018 May 1;98(5):302-314. doi: 10.1093/ptj/pzy030.

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

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035 The Smallest Worthwhile Effect of Physiotherapy Aug 17, 2018

How much of an improvement would you need to see in order to feel that physiotherapy was going to be worthwhile for your low back, neck, or shoulder pain? This is the question that this study examines and that is discussed in this episode. Also Sandy considers opening a steak restaurant.

The smallest worthwhile effect of primary care physiotherapy did not differ across musculoskeletal pain sites. Christiansen DH, de Vos Andersen NB, Poulsen PH, Ostelo RW. J Clin Epidemiol. 2018 May 28. pii: S0895-4356(17)31379-3. doi: 10.1016/j.jclinepi.2018.05.019. [Epub ahead of print]

Due to copyright laws, unless the article is open sourcewe cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

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034 How Well Do We Remember Past Pains? Jul 05, 2018

In this episode the topic of pain memory recall is explored. How well do we remember our past pains? Are there differences in recall between populations? What might account for the differences when they occur? All of these topics covered in episode in which Sandy and Cory discuss a recent research article on the topic.

Hippocampal morphology mediates biased memories of chronic pain. Berger SE, Vachon-Presseau É, Abdullah TB, Baria AT, Schnitzer TJ, Apkarian AV. Neuroimage. 2018 Feb 1;166:86-98. doi: 10.1016/j.neuroimage.2017.10.030. Epub 2017 Nov 6. Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

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033 Reconsidering the IASP Definition of Pain May 22, 2018

In episode 33, Sandy and Cory are joined once again by Pain Specialist Physician, Milton Cohen. Dr. Cohen and his group have submitted a new clinical definition of pain. In the discussion, we unpack the new definition term by term and discuss issues that Dr. Cohen and his group have spelled out regarding the current and famous IASP definition. Does the current definition have important shortcomings? Do you feel that patients would agree that the current definition fits with the experience of being in pain? Does this new definition make the clinical encounter and potential directions of treatment more clear? Listen in and judge for yourself. Be sure to catch a call to action as well as a bonus discussion of the new 'nociplastic' category of pain at the end of the show.

Reconsidering the International Association for the Study of Pain definition of pain. Cohen M, Quintner J, van Rysewyk S. Pain Rep. 2018 Mar 5;3(2):e634. doi: 10.1097/PR9.0000000000000634. eCollection 2018 Mar.

A rebuttal article also referenced in the show: The International Association for the Study of Pain definition of pain: as valid in 2018 as in 1979, but in need of regularly updated footnotes. Treede RD. Pain Rep. 2018 Mar 5;3(2):e643. doi: 10.1097/PR9.0000000000000643. eCollection 2018 Mar.

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

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032 Are There Ethical Concerns With Mindfulness Approaches? Mar 22, 2018

A recent paper looks at the philosophical underpinnings of the practice of mindfulness and raises some concerns regarding the ethics of its use. In this episode, these concerns are discussed as well as the larger implications of informed consent and respect for patient values.

Forgetting ourselves: epistemic costs and ethical concerns in mindfulness exercises. Ratnayake S, Merry D. J Med Ethics. 2018 Mar 9. pii: medethics-2017-104201. doi: 10.1136/medethics-2017-104201. [Epub ahead of print] Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

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031 Expectancy Violation Update Feb 10, 2018

We return to exposure based therapy and an update of the topic covered in the popular episodes 12 and 15, expectancy violation. This time we discuss a clinical commentary paper reviewing the state of the evidence related to the claims of Craske et al. How have the claims held up? What is the state of the science on the topic? This and more in episode 31.

Exposure therapy augmentation: A review and extension of techniques informed by an inhibitory learning approach. Weisman JS, Rodebaugh TL. Clin Psychol Rev. 2018 Feb;59:41-51. doi: 10.1016/j.cpr.2017.10.010. Epub 2017 Oct 26.

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

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Episode 30: I am a Placebo: An Interview With Dr. Nortin Hadler, MD Dec 28, 2017

Our guest in this episode is Dr. Nortin Hadler, a rheumatologist and professor of medicine at the University of North Carolina in Chapel Hill, who has spent decades right in the middle of several health care debates. Dr. Hadler, or as Sandy likes to call him "Quote Machine," spent an hour with us reflecting on a range of topics. What is medicalization and why is so important? What predicts poor health outcomes related to regional pain disorders most robustly? What is the difference between a treatment act and a treatment encounter? Why do people shop in the placebo aisle of the grocery store? How is a well intentioned provider to proceed with care? All of this and much more in this episode.

Links to his books via Amazon:

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029 Discussion of the book Meanings of Pain Nov 25, 2017

This episode has Sandy and Cory discussing a recently released book, tilted Meanings of Pain. Can we measure pain? What is the impact when we try? How do the roles we assume impact the care we provide and how it is received? Listen in as our hosts consider these and other topics that have been raised by this very interesting and comprehensive book.

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

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028 Does Manual Therapy Suck? Oct 28, 2017

In this episode of Pain Science and Sensibility, it’s another British Invasion! So, I guess that would make us the Ed Sullivan show? Special guest Adam Meakins, host of the NAF physio podcast, joins us for a discussion regarding his proclamation that “Manual Therapy Sucks.” His provocative stance has stirred a lot of attention and discussion. So, stepping away from our normal format of discussing a specific paper, in this episode we’re discussing the merit, or lack thereof, for manual therapy. Also, is there a 6 degrees of Greg Lehman effect?

Manual Therapy SUCKS... Meakins A. The Sports Physio. 2017 Sep 29.

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

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027 Transverse Abdominals in Low Back Pain Sep 19, 2017

Sandy and Cory discuss a popular topic in the treatment of low back pain; the role of the transverse abdominus. This paper examines the role in pregnancy related low back pain but the episode goes on to discuss the topic more broadly. Now suck in that naval and listen along!

The transverse abdominal muscle is excessively active during active straight leg raising in pregnancy-related posterior pelvic girdle pain: an observational study. Mens JMA, Pool-Goudzwaard A. BMC Musculoskelet Disord. 2017 Aug 25;18(1):372. doi: 10.1186/s12891-017-1732-9.

026 Can We Predict Who's at Risk for Persistent Pain Aug 18, 2017

What is stratified care? Can we get the right patients to the right care at the right time? In this episode we look at a study examining some of the background required to answer these questions. Can we predict who is at risk for developing persistent pain? If we can then we might be better able to direct them to the right care. The findings may surprise you.

The Value of Prognostic Screening for Patients With Low Back Pain in Secondary Care. Karran EL, Traeger AC, McAuley JH, Hillier SL, Yau YH, Moseley GL. J Pain. 2017 Jun;18(6):673-686. doi: 10.1016/j.jpain.2016.12.020. Epub 2017 Jan 30.

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

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025 Comparing and Using Low Back Pain Clinical Guidelines Jun 29, 2017

Episode 25 has our hosts, and special guest Kelly Newman SPT discussing a recent review article comparing 3 of the major clinical guidelines for the treatment of low back pain. What is a clinical guideline? How are their recommendations established and why are there differences between them? What is "the burden of proof" and why is it relevant to this discussion?

Clinical guidelines for low back pain: A critical review of consensus and inconsistencies across three major guidelines. O'Connell NE, Cook CE, Wand BM, Ward SP. Best Practice & Research Clinical Rheumatology. 2017. http://dx.doi.org/10.1016/j.berh.2017.05.001

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

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024 Trigger Points, the "Third Space", and the Merit of Pain Theories with Dr. Milton Cohen Jun 01, 2017

Special Guest Milton Cohen MD, Rheumatologist/Specialist Pain Physician, joins the show to discuss a variety of topics in this far ranging interview. Dr. Cohen and his research group has written extensively on topics ranging from critical appraisals of the biomedical and biopsychosocial framework to the nature of the therapeutic interaction. In the show we discuss these topics as well as the concept of the "Aporia" of pain. Additionally, his group's 2015 paper on the face validity of the trigger point phenomenon that was widely debated on social media is discussed in addition to their concerns with Moseley and Vlaeyen's "Imprecision Hypothesis" of pain.

A critical evaluation of the trigger point phenomenon. Quintner JL, Bove GM, Cohen ML. Rheumatology (Oxford). 2015 Mar;54(3):392-9. doi: 10.1093/rheumatology/keu471. Epub 2014 Dec 3.

Pain medicine and its models: helping or hindering? Quintner JL, Cohen ML, Buchanan D, Katz JD, Williamson OD. Pain Med. 2008 Oct;9(7):824-34. doi: 10.1111/j.1526-4637.2007.00391.x.

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

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023 Modeling Pain and Other Bayesian Topics May 11, 2017

Episode 23 has Sandy and Cory discussing a review article about modeling pain using a Bayesian statistical model. Fear not! You'll not need an abacus to follow along as the discussion moves from considering the model to potential use and problems with the "Bayesian Brain" concepts that are currently en vogue. What is the big deal with Bayes theorem? Why has it become so popular and why is it being applied to pain?

Pain: A Statistical Account. Tabor A, Thacker MA, Moseley GL, Körding KP. PLoS Comput Biol. 2017 Jan 12;13(1):e1005142. doi: 10.1371/journal.pcbi.1005142. eCollection 2017 Jan.

Also mentioned in this episode: https://blogs.scientificamerican.com/cross-check/are-brains-bayesian/ http://thesciencept.com/because-you-know-im-all-about-that-base/ http://thesciencept.com/learning-from-experience/

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

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022 Do Systematic Biases Impact Care? Apr 11, 2017

Episode 22 has Sandy and Cory discussing a systematic review on whether biases are present in healthcare decisions and if so, do they have a negative impact. Are biases something that we need to worry about? Is Cory a robot? Also, Sandy coerces her DPT student Christa Wolf to join the show for an important perspective from the student side. Take a listen as the crew discusses these matters and their implications in matters such as the concept of N of 1.

Cognitive biases associated with medical decisions: a systematic review. Gustavo Saposnik, Donald Redelmeier, Christian C. Ruff, and Philippe N. Tobler. BMC Med Inform Decis Mak. 2016; 16: 138. Published online 2016 Nov 3. doi: 10.1186/s12911-016-0377-1

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

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21 Aerobic Exercise for Pain Mar 07, 2017

In this episode, Sandy and Cory are joined by special guest Roderick Henderson who is a physical therapist and strength coach. The group reviews a recent article on the impact of aerobic exercise on pain sensitivity and also goes on to talk about several topics concerning strength and conditioning aspects of care for people in pain. How much should we push our patients in pain? What constitutes "strength training?" Is Rod being attacked by a pack of wild dogs?

Effects of aerobic exercise on pain sensitivity, heart rate recovery, and health-related quality of life in patients with chronic musculoskeletal pain. Öte Karaca Ş, Demirsoy N, Günendi Z. Int J Rehabil Res. 2016 Dec 29. doi: 10.1097/MRR.0000000000000212. [Epub ahead of print]

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

Music by Kevin MacLeod - incompetech.com: Intro - Brandenburg No4 and Meatball Parade Close - Meatball Parade

020 Neuropathic Pain at the Pelvis Jan 16, 2017

In episode 20 Sandy and Cory discuss an exploratory research paper on Sandy's area of expertise, pelvic pain. The presence or absence of neuropathic pain in this population is not well known and Sandy provides some insight into how this gap along with some common misconceptions play out in unfortunate ways for patients with these presentations. Cory's mettle is tested once again in another low front pain episode but he contributes a self report question that is sure to make you wink. There are some interesting similarities with other, more well understood conditions of the body. For example, what is the "disk herniation" equivalent of pelvic pain?

An Exploratory Study into Objective and Reported Characteristics of Neuropathic Pain in Women with Chronic Pelvic Pain. Whitaker LH, Reid J, Choa A, McFee S, Seretny M, Wilson J, Elton RA, Vincent K, Horne AW. PLoS One. 2016 Apr 5;11(4):e0151950. doi: 10.1371/journal.pone.0151950. eCollection 2016.

Open Access at the time of release.

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

Music by Kevin MacLeod - incompetech.com: Intro - Brandenburg No4 and Meatball Parade Close - Meatball Parade

Holiday Extravaganza 2016 Dec 11, 2016

The PT Podcast Network crew are here to spread some holiday cheer with the annual PT Podcast Network Extravaganza! They talk Jedis, rectums, Festivus, and horrible jet lag - all the holiday standards. Some say it's unlistenable...but you get to judge for yourself!

Music for The PT Podcast Holiday Extravaganza: Kevin MacLeod - incompetech.com

018 What IS a Picture Worth Nov 13, 2016

Cory and Sandy continue their search for clinical excellence (and interesting new screening tools), including an in-depth look at the benefit of using pain drawings as part of clinical assessment. Can these drawings be used to indicate signs of central sensitization? If not, are they useful anyway? How excited is Cory about the Cubs in the World Series?

Expanded Distribution of Pain as a Sign of Central Sensitization in Individuals With Symptomatic Knee Osteoarthritis. Di Lernia D, Serino S, Cipresso P, Riva G. Phys Ther. 2016 Aug;96(8):1196-207. doi: 10.2522/ptj.20150492. Epub 2016 Mar 3.

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

Music by Kevin MacLeod - incompetech.com: Intro - Brandenburg No4 and Meatball Parade Close - Meatball Parade

017 Are There Ghosts in Your Machine Oct 06, 2016

In episode 17, Sandy and Cory attempt to tackle a difficult theoretical paper (difficult for non-neuroscientists, at least) discussing some potential implications of interoception in chronic pain. The discussion wades into "embodied cognition" and "predictive processing" among many other models that this paper attempts to cover. Also, we uncover the real reason why Sandy is going to Japan.

Ghosts in the Machine. Interoceptive Modeling for Chronic Pain Treatment. Di Lernia D, Serino S, Cipresso P, Riva G. Front Neurosci. 2016 Jun 30;10:314. doi: 10.3389/fnins.2016.00314. eCollection 2016.

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

Music by Kevin MacLeod - incompetech.com: Intro - Brandenburg No4 and Meatball Parade Close - Meatball Parade

016_CBT_in_the_Workplace Aug 28, 2016

In this episode Sandy and Cory discuss a recent RCT in which a CBT approach was applied to the workplace. Cory works in the occupational setting and so is able to offer some insight into how this type of care might be provided. The discussion goes in some interesting directions as both of our co-hosts feel that there is application for these findings no matter the setting. Also, we find out that both Sandy and Cory are planning evil deeds for their cats.

Early Workplace Communication and Problem Solving to Prevent Back Disability: Results of a Randomized Controlled Trial Among High-Risk Workers and Their Supervisors. Linton SJ, Boersma K, Traczyk M, Shaw W, Nicholas M. J Occup Rehabil. 2016; 26: 150–159.

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

Music by Kevin MacLeod - incompetech.com: Intro - Brandenburg No4 and Meatball Parade Close - Meatball Parade

015 Maximizing Exposure Therapy Revisited Jul 28, 2016

In this special episode of Pain Science and Sensibility we are co-releasing with the Naked Physio Podcast, joining up with Paul Lagerman and Bronnie Thompson (who you may remember was also a special guest on Episode 11) to revisit and expand thoughts on the Inhibitory Learning paper from Episode 12. Listen in as Sandy and Cory learn that their inventive pronunciation skills can also be applied to places in New Zealand.

Episode 14: Motor Control and Walking for Pain Jun 19, 2016

In episode 14, Sandy and Cory take on a Cochrane review looking at trunk motor control exercises for low back pain and another paper comparing specific exercise vs. just walking in low back pain. The findings may surprise you. As a special treat, guests Mike Stewart of "Know Pain Mike" fame, and Andrew Rothschild join in for the clinical application discussion. Sandy tries to keep Cory awake as he suffers from severe caffeine deficiency throughout the show.

013 Pelvic Floor Hyperalgesia May 24, 2016

We're talking about pelvises (or is it pelvi?) on episode 13! We discuss a specific paper that is both specific to pelvic pain and highlights some controversies that are more general in pain science. This is in Sandy's wheel house and she doesn't disappoint as she walks through some clinical applications while Cory tries to compensate for his discomfort with bad jokes.

012 Maximizing Exposure Therapy Apr 03, 2016

In this episode of Pain Science and Sensibility Sandy and Cory dive into some specific applications of Graded Exposure some of which are very surprising and may have some astounding implications for what we do with our patients. Are we accidentally encouraging "safety behaviors" that may negatively impact progress? When is the best time to educate the patient in attempt to provide explanations or change cognitions? The answers, at least according to this approach, may shock you.

011 Function vs Activity Mar 06, 2016

In Episode 11 Cory and Sandy get pedantic about the definition of "function" vs "activity" and are joined by a surprise guest when Dr. Bronwyn Thompson wanders by. Sandy learns another tool for helping her patients with sleep challenges and we get to nibble on a muffin and sip coffee while Bronnie teaches us some Kiwi words and a different perspective on activity and engagement.

010 Neurodynamics and Fibromyalgia Jan 18, 2016

In this episode, Sandy and Cory discuss the popular treatment method of neurodynamics. While discussing a recent RCT which used the method in a group of patients with a fibromyalgia diagnosis the hosts also go in to some depth of how they use neurodynamics in the clinic. Also, Sandy's secret mission to convince Cory that he's a pelvic health therapist in denial continues.

Holiday Extravaganza Dec 14, 2015

It's that time of year again and the PT Podcast Network crew are in the holiday spirit! The gang got together, as best they can scattered across the world, to share a little eggnog and make fun of each other. So pour yourself a drink, sit by the fire (or pool in the Southern Hemisphere), and enjoy a little holiday cheer.

008 Pain: Of Mice and Men? Dec 01, 2015

How do you know if a mouse feels pain? Not to spoil the surprise, but it involves being stuffed head first into a glove. What might this mean for us larger animals? In this episode, Sandy and Cory discuss an animal study article which examines the role of exercise and pain. Grab a beverage and pull up your hamster wheel for Episode 8!

007 CBT for Chronic Pain Delivered Through the Internet Nov 01, 2015

Episode 7 explores two studies on the effects of a cognitive behavioral therapy program for chronic pain delivered through the internet. This is obviously the first step toward a post apocalyptic version of reality in which we are ruled by our computer/machine overlords. Or is it? The fate of world may depend on this episode! Also, Cory is a dumbass. These are among many probing topics in this episode of Pain Science and Sensibility.

006 To Exercise or Not to Exercise with Chronic Pain Oct 08, 2015

Which patients with persistent pain will flare up with exercise? Should they exercise? In episode 6 Sandy and Cory discuss a paper that tackles these difficult questions while interjecting the normal clinical commentary of how they address these scenarios in their own practice settings. Also, Sandy cuts down the grandest tree in the forest with a herring. But will she get a shrubbery?

005 Follow-Up Discussion to the James McAuley Interview Sep 15, 2015

Episode 5 is a short (30 min) follow up to Episode 4. James McAuley provided so much great information to consider that Sandy and Cory needed more time to discuss applications to the clinic.

004 Revisiting Self Efficacy with James McAuley Aug 30, 2015

In this interview episode of Pain Science and Sensibility, Sandy and Cory are joined by guest Dr. James McAuley, PhD. James was an author of the article discussed in episode 1 as well as a recent systematic review and meta-analysis of mediation studies of self-efficacy. The crew discuss this and James offers some brilliant insight into both the research surrounding self efficacy as well as its application to the clinic. This one is jam packed with information so get ready to get your learn on!

003 Catastrophizing and Graded Exposure Aug 05, 2015

In episode 3, Sandy and Cory discuss a research article on the role of catastrophizing and it's impact on the effectiveness of graded exposure treatments. They discuss how they look at catastrophizing in the clinic and the difficulty of graded exposure. Sandy discusses the clinical skills that she's gained from improvisational acting. Cory learns, much to his dismay, of the association between Pokémon and cheap liquor.

002 New Theory of Chronic Pain Jul 01, 2015

In episode 2, Sandy and Cory discuss the "Imprecision Hypothesis of Chronic Pain" recently published by Lorimer Moseley and Johan Vlaeyen. Potential clinical implications are discussed as well as a rebuttal that has already been submitted. Hard hitting questions are tackled, like "Is pain a stimulus or a response?", "How does associative learning apply to clinical treatment?", and "Does Cory have the mental fortitude to beat a 5 year old in Battleship?"

001 Self-efficacy and Fear of Movement in Chronic Back Pain Jun 09, 2015

In the first ever episode of the Pain Science and Sensibility Podcast Sandy and Cory explore a recent research article on self-efficacy and fear of movement and how they mediate changes in pain and/or disability in chronic back pain populations. They discuss how these findings apply to the clinic and Cory tries to convince Sandy to open a pizza place in her clinic.

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