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

Sleep and Pain


Sleeeeep!! Mmmmmm we all need it, it’s a necessary part of mind and body function and for life. Yet when we suffer from pain and particularly persistent pain, it can really disturb our sleep. So we assume that pain is the culprit for disturbing our sleep, right? Well this may not be entirely accurate. The thinking on pain and sleep is changing, and compelling evidence is identifying some important physiological functions that occur when we sleep revealing that how sleep may have more of an effect on pain. … More Sleep and Pain

31 days project: The Big Naked Pain and Brain Campaign: Day 31


Day 31 the final day of the big naked pain and brain campaign – getting stronger! I thought about the final clip a lot and pondered on a few ideas taking suggestions from other people interested in the project and the end result seemed to fit. I think it was best to end with this … More 31 days project: The Big Naked Pain and Brain Campaign: Day 31

31 days project: The Big Naked Pain and Brain Campaign: Day 1


Day 1 of the Big Naked Pain and Brain Campaign – Tom and Jerry I could have chosen loads of cartoons, Warner Bros, Disney etc but for me Tom and Jerry had to be the most obvious choice to start off the official 1st day! Tom and Jerry are renowned for getting themselves into all … More 31 days project: The Big Naked Pain and Brain Campaign: Day 1

Mirror Mirror on the wall why do I experience pain with no movement at all?


Mirror mirror on the wall why do I experience pain with no movement at all? It’s your mirror neurons. Mirror neurons? What on earth are those? You might not believe it and it’s certainly not the stuff of fairy tales but mirror neurons were apparently discovered in the brain having an important role in allowing animals to understand movement. Mirror neurons are understood to be specialized nerves that actually fire when you recognize a movement performed by another individual. In the context of pain that is pretty important. The following post will discuss how mirror neurons might play a significant part in your pain experience. … More Mirror Mirror on the wall why do I experience pain with no movement at all?

Physiotherapy Rehabilitated: Change


The final part of my Pain series had intended to look at the current management approaches for persistent pain. I thought about this and decided against it. Why? Well teaching you to suck eggs is not the way. I could offer the same as everyone else – solutions, guidance, strategies to empower you, to aid in the management of pain which has, in part, been highlighted in this pain series journey, but I won’t. Instead I’ll share my thoughts on physiotherapy and how new evidence is paving to what I believe could be a more refined direction for Physiotherapy…… … More Physiotherapy Rehabilitated: Change

2015: A new year for more nakedness


This is a brief thank you to all that have supported thenakedphysio this year. The last 5 months of 2014 writing my blog page has seen a mixture of thoughts, reactions, inspiration and collaboration. Having had some real eye-opening discoveries during my clinical career and meeting like-minded people (one in particular) have inspired me to write and join the blogging world. I have received some real complements and criticisms this year already that were completely unexpected and those that…… well……. I did expect. … More 2015: A new year for more nakedness

Passive Therapies are they obsolete??


Manual Therapy is the bread and butter some clinicians might say when it comes to treatment. There are various schools of thought on treatment application. This is a short report on my thoughts on Passive therapies and the evidence and critiques surrounding it. The discovery of pain science and a better understanding of brain neurophysiology has changed the way we think about treating patients. … More Passive Therapies are they obsolete??

Tears of acceptance – months of unknown


The turmoil of the unknown, living with pain, months/years of suffering, it’s a huge journey, something that I have never personally experienced for such a duration. Yet it is a common experience in everyday lives and is presented in many a clinical practice. Pain is the experience commonly presenting itself as a physical manifestation or disability to a persistent pain sufferer. It is fascinating how much pain can affect the human spirit, changing character, behavior and perceptions. This post reflects a clinical experience…… … More Tears of acceptance – months of unknown