Clinical Reasoning
Centralisation, Part 1: Mechanical pain, mechanical diagnosis and the Wrasse bite
Another great post from this blog by Louis Gifford. A blog well worth following.
Classification of Central Sensitisation, Nociceptive Pain and Peripheral Neuropathic Pain
Keith Smart and colleagues have published a number of articles, over the past year or two, in relation to classification of Central Sensitisation, Nociceptive Pain and Peripheral Neuropathic Pain. I think their findings are very useful in the clinical setting to guide us in our decision making. Recent articles ,published in Manual Therapy in 2012, identified […]
Masqueraders of Spinal Pain
In addition to the Henschke et al article that I referred to in the last post, I also thought it important to review potential Masqueraders of Spinal Pain. I reviewed an article by Klineberg et al (2007) that provides examples of medical causes (Masqueraders) of back pain. Something I think as primary contact practitioners we should be […]
Red Flags
I reviewed a recent article by Henschke et al (2009) in relation to Red Flags titled: Prevalence of and Screening for Serious Spinal Pathology in Patients Presenting to Primary Care Settings With Acute Low Back Pain The purpose of this study being to determine prevalence of serious pathology in patients presenting with acute lower back pain […]
Cervicogenic Headache
Cervicogenic Headache (CGH) is a common clinical occurrence. The first challenge being to identify if the patient is suffering from CGH as either the primary problem or as a component of a mixture of headache types. This is not always easy as purely basing it on subjective findings can be difficult. Assessment of Headaches From […]
Assessment of Dizziness
In my clinical experience it would appear that patients presenting with dizziness is not uncommon. Is there a protocol for assessment of dizziness? I am certainly not an expert on dizziness, but I think the following information is a key minimum to know when assessing a dizzy patient. From a physiotherapy perspective I think the […]
Co-morbidities in Chronic Pain
Recently I have been reviewing the literature in relation to co-morbidities in chronic pain. The following list is taken from review of Ramond et al (2011), Von Korff et al (2005) and Coronado et al (2011). These are factors potentially related to poor prognosis and/or persistent pain states (I am sure there are more but […]
Classification of Radiculopathy and Peripheral Neuropathic Pain
Now before we start I want to state that most of my knowledge regarding this topic has developed from attending lectures/courses/practical sessions with Dr Toby Hall (Specialist Musculoskeletal Physiotherapist). I would encourage anyone reading this post to take any opportunity that arises to attend a course of Toby’s. He is a wealth of knowledge and […]
Cardiovascular Exercise for Chronic Pain
I am sure most of us send home patients with exercises to do. Potential aims being: Improved muscle strength/endurance Improve flexibility of muscles/joints Rehabilitating tendinopathies Improved motor control Pain relief Neural tissue “mobilisation” Etc, etc, etc. But what about cardiovascular exercise? Are there benefits of cardiovascular exercise for chronic pain? Why should we be encouraging […]
Hypothalamo-Pituitary-Adrenal Axis
I touched on the Hypothalamo-pituitary-adrenal axis in the last post. So what is the Hypothalamo-pituitary-adrenal (HPA) Axis and what do I think we need to know about it? The HPA Axis is: a central control and regulatory system of the organism that connects the central nervous system (CNS) with the hormonal system. This stress-responsive system […]
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