Tag: Central Sensitisation
Mechanical vs Non-Mechanical Pain
I wrote a while back about posting in relation to the “Inverted Pyramid”. The inverted pyramid principle is aimed at keeping what we do simple. I think as a profession we have a tendency to overcomplicate many things and “fluff” around doing and focusing on things that in some cases are of very little importance. Instead […]
Recommended Reading – Pain Classification – July 2015
Sorry for the lack of posts, I am busy with some updates of university lectures. As you can imagine I am a bit OCD about presenting up to date information in my lectures. Given the time constraints at the moment I thought I might post the occasional article I come across in my lecturing preparations […]
The Role of Manual Therapy
Now the most obvious key role of manual therapy is that it provides pain relief in some patients (for those interested in the research relating to the mechanisms of manual therapy this topic please see this previous post and this recent systematic review by Voogt et al (2014)). Pain reduction in patients is great, but there […]
Cold Hyperalgesia Testing
I have often read in the literature the view that Cold Hyperalgesia is suggestive of more “severe” pain states and hence poorer prognosis. For example: Van Oosterwijck et al (2013) reported in their Systematic literature review on the evidence for central sensitisation in chronic whiplash that: The outcome of the processes involved in central sensitization […]
Surgery for Shoulder Impingement
Is surgery for shoulder impingement of help to patients? I have no doubt that it helps some patients, but what is the evidence in regards to surgery versus conservative rehabilitation? The following literature caught my eye recently: Ketola et al (2013) A five-year randomised controlled trial examining the effectiveness of arthroscopic acromioplasty in the treatment of stage […]
Pharmacotherapy for Treatment of Neuropathic Pain – Research Evidence
Just a short post this time around…… I realise this is not directly related to physiotherapy treatment but given that patients with a dominance of neuropathic pain and/or central sensitisation (e.g. those patients with a positive LANSS or DN4 score for neuropathic pain) would seem to be the more difficult ones to improve, I think it […]
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 […]
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 […]
Central Sensitisation
I briefly discussed Central Sensitisation (CS) in a previous post on pain. CS has, at times, been a confusing topic. As mentioned in my last post on pain, based on my readings, CS is not a type of pain, it is a mechanism relating to pain. Understanding the mechanism is helpful in understanding the symptoms. […]
Stimulus-Dependent and Spontaneous Pain
I think that one of the key things we should look for in the patient assessment is the behaviour of pain. Is the pain Stimulus-dependent and/or Spontaneous pain. The “evoking” of pain can be an important aspect to ascertain in the subjective and objective examination. The diagrams at the end of this post (from Costigan […]
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