Pain Science and Sensibility

Latest Episodes:

053 Is Therapeutic Alliance a Bust? Oct 27, 2021

Show notes

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

Show notes

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.

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

2020 PT Podcast Network Holiday Extravaganza Dec 14, 2020

Show notes

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

050 Pain Flare-Up Nov 16, 2020

Show notes

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

Show notes

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

Show notes

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

Show notes

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]

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

Show notes

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.

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

Show notes

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.

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

Show notes

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]

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