Pain Science and Sensibility

Latest Episodes:

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

Show notes

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.

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

023 Modeling Pain and Other Bayesian Topics May 11, 2017

Show notes

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/

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

022 Do Systematic Biases Impact Care? Apr 11, 2017

Show notes

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

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

21 Aerobic Exercise for Pain Mar 07, 2017

Show notes

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]

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

020 Neuropathic Pain at the Pelvis Jan 16, 2017

Show notes

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.

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

Holiday Extravaganza 2016 Dec 11, 2016

Show notes

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

Show notes

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.

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

Show notes

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.

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

016_CBT_in_the_Workplace Aug 28, 2016

Show notes

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.

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

015 Maximizing Exposure Therapy Revisited Jul 28, 2016

Show notes

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.

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