CRPS Series: Are we assessing appropriately?


Complex Regional Pain Syndrome (CRPS) is an incredibly debilitating condition. It effects the peripheral limbs specifically the hands and feet.  CRPS usually occurs following trauma to the limb, commonly a fracture but also sprains, strains and crush injuries (Bruehl, 2015). It has also been recorded to occur following minor trauma such as a bee sting … More CRPS Series: Are we assessing appropriately?

Posture: the ongoing debate


Posture, wow it’s a popular topic, particularly in primary and community healthcare. You literally can’t go a day without seeing something that relates to improving or “correcting” your posture. Your health professional (that’s physio, chiro, osteo, pilates teacher, massage therapist, personal trainer, the media) has I’m sure at one time talked to you about posture … More Posture: the ongoing debate

Knee Osteoarthritis, bracing, surgery, exercise and pain


Osteoarthritis is the most common arthritic complaint among older adults with pain, loss of function, disability and reduction in quality of life being the result. Pain is reported to be the most common complaint for people to undergo a total knee replacement (TKR), with the understanding being that the damage in my joint is causing … More Knee Osteoarthritis, bracing, surgery, exercise and pain

Running reduces the risk of death up to 63%, but that’s not all it does!


That’s a huge percentage! Yes, according to recent evidence (Artero et al., 2012) running really does reduce the risk of death by 63%! As the title suggests this relates to cardiovascular disease and all-cause mortality (cause of death), which includes other chronic conditions such as obesity, diabetes and cancer. Lee et al (2014) identified that … More Running reduces the risk of death up to 63%, but that’s not all it does!

What can whale poo teach us about biomechanics and pain?


  Yeah whales, humans, biomechanics and pain. Thanks to Ben Cormack (a real geezer) from CorKinetic for his contributions to this blog. The video above on whales and their contribution to our planet is not only informative and enlightening but also serves as a great metaphor for our understanding of the human body. Confused? Intrigued? Then … More What can whale poo teach us about biomechanics and pain?

CRPS Series: Hand, you see it? Now you don’t. Hand, you feel it? Now you don’t.


‘Now you see it, now you don’t’ is a popular idiom that magicians use whilst performing illusions, with the intention of leaving the viewer flummoxed. The phrase is used to express that something is gone without clear explanation of how and why. Take the rubber hand illusion (RHI) for example, this is an interesting neurological … More CRPS Series: Hand, you see it? Now you don’t. Hand, you feel it? Now you don’t.

Complex Regional Pain Syndrome Series: Peripheral Inflammation


Complex Regional Pain Syndrome (CRPS) is a complex and poorly understood problem. There have been several proposed interacting pathophysiological features of the condition including altered sympathetic nervous system function, central sensitisation, inflammatory factors, immune factors, genetic factors, brain changes and psychological factors (Bruehl, 2015; Marinus et al., 2011). Most diagnostic criteria come from clinical features … More Complex Regional Pain Syndrome Series: Peripheral Inflammation

Clinicians Get Creative: Creative Ways to Reframe Pain


Ready to engage with people living with pain in a creative way? I like to think that with all the courses, blogs and content on social media out there, clinicians have a better understanding of language use, creativity and communication skills. Well, you might think that but then your likely mistaken. There’s still much to do … More Clinicians Get Creative: Creative Ways to Reframe Pain

Complex Regional Pain Syndrome series: Visual distortion


Ever since I read Moseley et al’s (1) paper back in 2009 on visual distortion I was instantly succumbed to the idea of embodiment and wanting to work with people living with Complex Regional Pain Syndrome (CRPS). I admit I didn’t fully understand what embodiment was back then, but there was a small part of … More Complex Regional Pain Syndrome series: Visual distortion

Living with Pain and Goals: Should they be SMART, MEANINGful or VAPID?


I have a goal, a goal to reduce my social media time. Why? Cause it can make me miserable! It distracts me from more important things and it can engage me in conversations that are just… well… pointless! That’s a whole heap of productive time, lost! Anyway that’s my problem, my own personal issue and something … More Living with Pain and Goals: Should they be SMART, MEANINGful or VAPID?

Everybody wants a piece of the pain pie


Over the last week I’ve been travelling (with a small team from the company I work for) around the north island of New Zealand delivering in-service training talks to allied health professionals, (Physios, OTs, Psychs, counsellors, medical specialists) about the new Accident Compensation Corporation pain service that has been rolled out nationwide across NZ. My … More Everybody wants a piece of the pain pie

50 ways of thinking differently in pain science: Part 2


Welcome to part 2 of my 50 ways of thinking differently in pain science. I got the idea after reading an Auckland chamber of commerce article that applied the title to business.  I thought to myself there are a lot of similarities here in thinking in business and pain science. Nothing like a bit of healthy … More 50 ways of thinking differently in pain science: Part 2

50 ways of thinking differently in pain science: Part 1


I was flicking through an Auckland chamber of commerce magazine recently (it’s nice to draw creativity from other business sectors) and came across an article ’50 ways of thinking differently’ so I decided to create my own for pain science. This list is an attempt to demonstrate the level of creativity we can have when working with people with … More 50 ways of thinking differently in pain science: Part 1

Bridging the Pain Gap: My NZ massage article


Hi all I recently had the fortunate opportunity to have an article published in NZ massage magazine. I wanted to share my thoughts with the evidence on the changing landscape in understanding pain and its multi-dimensional nature. I decided to share a small reflection on the article to highlight the change in my own personal growth … More Bridging the Pain Gap: My NZ massage article

Understanding the Biopsychosocial reasoning process in chronic back pain: A single case study part 3


The 3rd part of this series of naked tales of a studying physio picks up from where we left part 2. Here I talk about my observations and formulate my case for management.  You can read parts 1 and 2 here and here.  Observations Interestingly, as the patient walked into the examination room it was observed … More Understanding the Biopsychosocial reasoning process in chronic back pain: A single case study part 3

Understanding the Biopsychosocial reasoning process in chronic back pain: A single case study part 2


It’s that time again for another helping of the naked tales of a studying physio. So let’s pick up from where we left off.  If you want a refresh of part 1 you can do so here   Treatment History The patient’s spinal fractures were managed conservatively over the course of 5 months with a spinal … More Understanding the Biopsychosocial reasoning process in chronic back pain: A single case study part 2

The work compensation frustration – a guest post by Joletta Belton


I haven’t had a good guest post in a long time! So I thought, I should really have a guest post. Low and behold ask and you shall receive!! Many of the people I see living with long term pain are on a workers compensation (WC) scheme. It can be a pretty stressful ordeal for them … More The work compensation frustration – a guest post by Joletta Belton

The case for and the case against: a short blog on clinical reasoning


Our clinical practice should demonstrate a good mix of acquired knowledge, clinical experience and supporting evidence. The person seeking care expects to receive a well-reasoned intervention hypothesis that answers questions or concerns, and delivers effective management.   So, evidence based medicine appears to be cropping up everywhere at the moment. That’s not inherently a bad … More The case for and the case against: a short blog on clinical reasoning

Understanding the Biopsychosocial reasoning process in chronic back pain: A single case study


Hi all welcome to another naked tales of a studying physio. Here’s the first part of my second assignment for my post-graduate studies. It’s a back pain case study about a thoracic disc herniation and calcification. A small note before you read on. There is minimal evidence (very low quality) (all case studies) that show … More Understanding the Biopsychosocial reasoning process in chronic back pain: A single case study

Don’t get caught with your pants down – 5 naked tips


As part of our professional development we need to maintain a reasonably competent knowledge of evidence base practice. Yet, do you ever feel like you’re chasing your tail? Perhaps you don’t know your left from your right? Maybe you feel like you’re stuck on the fairground Ferris wheel or maybe you’re just going round in circles…? … More Don’t get caught with your pants down – 5 naked tips

Using the BPS model in clinical practice – Part 2


Hi all, after a pretty good response from part 1 here’s the follow-up to the naked tales of a studying physio – using the BPS model in clinical practice. I want to say thanks for the feedback for part 1, but more critical analysis is desirable. I mean I can’t imagine i’m that good a writer that … More Using the BPS model in clinical practice – Part 2

Using the BPS model in clinical practice – Part 1


Hi all here’s another instalment of the naked tales of a studying physio. Part 1 of my first assignment from my postgraduate studies. I’ve decided to share it with all my readers as I want your thoughts and opinions on this. The more we engage in collaborative communication and sharing of knowledge the better we can … More Using the BPS model in clinical practice – Part 1

It’s all in your head, that’s ok or maybe not?


It’s important to acknowledge that we can have two sides of the spectrum when discussing notions of pain with patients. A recent masterclass article in manual therapy by Nijs et al, (2013) highlight that the biomedical framework is the core of most clinicians training and yet ‘it falls short in explaining and treating chronic musculoskeletal … More It’s all in your head, that’s ok or maybe not?

We’re not worthy! Being drawn into Wayne’s World


There’s a particular part in the movie Wayne’s World where Wayne and Garth meet Alice Cooper. They both drop to their knees and proclaim “We’re not worthy” because of their admiration of Alice’s talent and fame. This scene reminds me of some of what we see with current pain education practice. This post is a … More We’re not worthy! Being drawn into Wayne’s World

San Diego Pain Summit – post summit thoughts


After what can only be described as an excellent few days of meeting and greeting, rubbing shoulders and entertainment the San Diego Pain Summit lived up to my expectations! So I share with you some short post summit thoughts on my favourite talks, finishing with my thoughts of my presentation – clinicians get creative. The first … More San Diego Pain Summit – post summit thoughts

Whose Pain is it Anyway?


The popular comedy game show “Whose Line is it Anyway?” invites comedians to make up small skits around random topics that are suggested by either the game show host or the audience. The show is a mix of impromptu lines, humour, spontaneity, and sometimes confusion. Listening and acknowledging each others’ lines is a necessary part … More Whose Pain is it Anyway?

Pre-surgical biopsychosocial screening: Is there a need? – a guest post by Robin Higginson


Our current assessment procedure is still widely used and taught throughout physiotherapy training. It is in my opinion, an area that requires serious reform. The emergence of the biopsychosocial model has shifted our understanding to a wider clinical landscape, one that lies outside of a biomedical paradigm. Shouldn’t our own assessment procedure reflect that and is … More Pre-surgical biopsychosocial screening: Is there a need? – a guest post by Robin Higginson

Burn out? How it happens and what to do about it – a guest blog from Averil Linn


Burn out can be a real problem for clinicians, I’ve suffered with it, but it’s not just clinicians it can affect all of us! So why does it happen and what should we do about it? Well I am very fortunate to have asked Averil Linn, who specialises in behaviour change, to write a guest … More Burn out? How it happens and what to do about it – a guest blog from Averil Linn

The nervous system – a phenomenological artistic perspective of pain


I have worked in the field of persistent pain for 8 years, I am continuously challenged.  I get stuck and frozen by the complexity of presentations, because no two presentations are the same, despite the fact that those two very different presentations have a referral for the same pain problem (back pain for example). People experience … More The nervous system – a phenomenological artistic perspective of pain

The Big Naked Pain and Brain Campaign: Extra extra!


Extra extra! The big naked pain and brain campaign is back! I have continued to search high and low in the film industry for references towards pain! More wisdom from Yoda! ‘You must unlearn what you have learned’ and ‘do or do not there is no try’ This is a good example of what clinicians … More The Big Naked Pain and Brain Campaign: Extra extra!

Lack of fat on the toes causes numbness? – The shit we say


This is most definitely and unequivocally a rant! It’s a rant about the shit we say and what possesses us to say it. Actually, I’m not sure I can answer the second part of that question. I was listening to the radio the other day and an interview with a contestant from Dancing with the … More Lack of fat on the toes causes numbness? – The shit we say

Blood Flow Restriction a guest blog by Dr. James McCarron


Blood flow restriction has gained a lot more attention recently, and it’s certainly an area of interest for me as I have asked the question how useful it would be when applied as a tool for patients suffering with persistent pain. So what better way of getting an understanding than by asking the experts. … More Blood Flow Restriction a guest blog by Dr. James McCarron