Pain Science and Sensibility

Latest Episodes:

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

Show notes

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

Show notes

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

Show notes

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

Show notes

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.

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

Show notes

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

Show notes

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.

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028 Does Manual Therapy Suck? Oct 28, 2017

Show notes

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.

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027 Transverse Abdominals in Low Back Pain Sep 19, 2017

Show notes

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

Show notes

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.

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

Show notes

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

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