Pain Practice Support from Occupational Therapy Australia
HealthSkills Blog
by BronnieLennoxThompson
2w ago
This is a landing page for pain resources from Occupational Therapy Australia – click ..read more
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“Exercise” – what does it do for people living with persistent pain?
HealthSkills Blog
by BronnieLennoxThompson
2w ago
No, I’m not going to assemble a bunch of papers and point out the effect sizes of exercise on pain and disability! In fact, I’m not even going to point to much research in this post. I want to pose some questions and put some thoughts out for discussion. See, the people I’ve seen over the years who live with pain have, by and large, not been great ‘exercisers’ before their pain came on, and many haven’t really changed their lifestyle a heap since their pain either. In fact, there is research showing that people with chronic pain don’t change the overall quantity of their activity very much – b ..read more
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ACT plus exercise, vs exercise alone…
HealthSkills Blog
by BronnieLennoxThompson
3w ago
and what a shame there was no ACT alone group… No secret here, I like ACT (Acceptance and Commitment Therapy) as an approach for living well with chronic pain. I like it for many reasons, but probably the most compelling ones are that the hierarchy between therapist and person living with pain is minimised (we’re both humans finding our way through life) and that it doesn’t require the person to delve into challenging or disputing thoughts – this in turn enhances adherence to the core elements of ACT: living a life aligned with what really matters to this person. People seem to find using ACT ..read more
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Living with pain is social: The Chronic Pain Couple book review
HealthSkills Blog
by BronnieLennoxThompson
1M ago
Over the past year or so I’ve kept returning to ‘the social’ part of our multifactorial pain experience.* Pain can be extraordinarily isolating, and our current sociopolitical emphasis maintains a focus on ‘what the individual should do.’ In New Zealand, our accident compensation legislation is a no-fault, 24/7 everywhere, all-the-time innovation but it falls short in critical areas. One is the continued focus on ‘physical findings’ to validate a diagnosis (and to show that the resultant impact on an individual is entirely due to a personal injury caused by accident), and the other is the atte ..read more
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The difficult balance between evidence-based healthcare … and person-centred self-management
HealthSkills Blog
by BronnieLennoxThompson
1M ago
For decades I’ve been an advocate for evidence-based healthcare because the alternative is ’eminence-based healthcare’ (for healthcare, read ‘medicine’ in the original!). Eminence-based healthcare is based on opinion and leverages power based on a hierarchy from within biomedicine (read this for more!). EBHC appealed because in clinical practice I heard the stories of people living with chronic pain who had experienced treatment after treatment of often invasive and typically unhelpful therapies, and EBHC offered a sifting mechanism to filter out the useless from the useful. Where has EBHC led ..read more
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Circling back to supported self-management
HealthSkills Blog
by BronnieLennoxThompson
1M ago
I’ve been writing a bit about supported self-management over the last few months. Partly because it’s topical given that medications and exercise offer very small reductions in pain and disability, and people do have lives outside of swallowing a pill and doing 3×10 reps! And partly because it is what we end up doing. It is the bulk of what people living with pain use to have lives. Self-management refers to a broad range of strategies people with pain use in their daily lives to help them live well. I’m aware of the multiple definitions that exist for self-management, and that the level of ag ..read more
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Guarding and flow: an observational study
HealthSkills Blog
by BronnieLennoxThompson
1M ago
It’s been a while since I reviewed a paper but this one caught my eye! Amanda C. de C. Williams is one of my favourite researchers because her work captures social and anthropological aspects of pain – and she’s been researching and teaching for a very long time. This study is an observational study of physiotherapists watching videos of people with chronic low back pain doing movements. The movements are pretty decontextualised (ie they’re not integrated with everyday life activities) but they are the kinds of movement that people can find difficult. They were: reaching forward with arms hori ..read more
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Book review: Your Pain Playbook by Helen Roome
HealthSkills Blog
by BronnieLennoxThompson
2M ago
There is an enormous missing link in pain management today. That link is, as I see it, how to translate from theory (decontextualised ideas) to daily life. To my life, to your life, to the unique and varied lives people living with pain had before their pain arrived. Your Pain Playbook is written by Helen Roome, pain occupational therapist living and working in South Africa. The South African vibe runs through her book, giving this Kiwi a lovely taste of Helen’s country via the metaphors she uses – ever heard of the ‘Go-away bird’? It’s a bird that warns impala of impending danger and Helen us ..read more
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The words we use to talk about pain
HealthSkills Blog
by BronnieLennoxThompson
2M ago
Are you a ‘pain sufferer’? A ‘pain warrior’? A ‘pain victim’? Do you ‘ache’ or is it a ‘stabbing’ pain? Do you even know what ‘lancinating’ means? And let’s add in: are you a ‘catastrophiser’? Has your pain been developed through ‘chronification’? Is your body ‘unbalanced’ or ‘asymmetrical’? Do you ‘comply’ or ‘adhere’? Are you ‘motivated’? The ways we talk about pain are weird! We blithely use words, us clinicians and researchers (and yes, people with pain) without perhaps, really coming to grips with what the words mean – or what they say. One of the themes in qualitative pain research is th ..read more
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Self monitoring – focusing on pain too much? or an essential part of living with pain?
HealthSkills Blog
by BronnieLennoxThompson
3M ago
I was just a tiny bit surprised when I looked at the results of my self-management strategy survey: self monitoring was smack bang in the middle of the list! Take a look yourself – Self monitoring is not something we discuss much in pain management circles. It’s like ‘Oooh if you keep noticing your pain you’re fixating on it and that’s bad!’ and yet I suspect it forms part of the background interoceptive awareness that most of us do whether we live with pain or not. Let’s take a deeper look at it. The ‘definition’ I used was ‘noticing your pain intensity, thoughts, activities and varying your ..read more
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