Inaugural lecture Enrique Lluch Girbes as visiting professor at the Vrije Universiteit Brussel: ‘Osteoarthritis pain: understanding pain mechanisms & combining pain neuroscience education with Mulligan manual therapy’.
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Much of my early professional years were spent watching competitive sports. After 1-2 years in general practice I was hired by Tulane University in New Orleans, Louisiana, as Assistant Athletic Trainer. Tulane University competed in Division I Athletics which meant that a majority of their student athletes attended on a ‘full-ride’ scholarship; our ability to keep them healthy was taken quite seriously.
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In low back pain there are clear clinical differences seen between recurrent and chronic low back pain patients.
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When patients with chronic back pain present with poor body awareness, high stress levels, catastrophic thinking and fear-avoidance behaviors, physical therapists need biopsychosocial treatment interventions in addition to standard practices based on structural impairment to achieve pain relief and functional improvement.
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Neurodynamics or neural mobilisation is an intervention aimed at restoring the altered homeostasis in and around the nervous system (Coppieters and Nee 2015).
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A universally accepted term for the phenomenon ‘central sensitization’ in humans is not available yet and a proof of this fact is that its use in scientific literature is still under debate (Kosek et al. 2016).
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This is a question most clinicians dealing with people in pain must have asked themselves many times before. We have too.
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Resilience in the face of pain   October 31st, 2017
Readers of this blogpost are all aware of the huge impact that chronic pain has on both personal lives and society as a whole. The numbers speak for themselves and point to the urgent need for improvements in the ways we conceptualize pain in our theoretical frameworks and how this works out in clinical practice.
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The effect of exercise therapy has been extensively studied in health and disease. While it is broadly agreed that a program of exercises is beneficial, the same cannot be said for a single session. Symptoms worsening following exercise is indeed a common feature in people with chronic pain.
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In Belgium, every year, nearly 75.000 patients are diagnosed with cancer. That’s 205 patients a day, 9 patients an hour.
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I bet you all know someone in your close environment – a friend, family member, workmate - who suffers from chronic pain. Maybe chronic pain even controls your own life from time to time? Let me reassure you, you’re not the only one.
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Excepcional calidad de España   August 25th, 2017
Friday, July 14, 2017 in the beautiful Aulario V, Faculty of Physiotherapy of the University of Valencia (Spain): Enrique Lluch Girbés is defending his PhD in front of an international jury of experts.
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Similar as in adults, children’s pain experience occurs within a complex biopsychosocial framework. However, the presence of specific factors and their relative share in contributing to the development and maintenance of pain in children are distinct from those in adults.
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Objectively classifying and diagnosing different pain conditions remains a challenge for scientific research and clinical practice. Currently, self-report measures of pain and psychosocial factors are considered the gold standard for pain measurement and these measures perform well.
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Since the Cartesian model and the understanding of ‘a nervous system’, there has been a dualistic approach of pain. Especially in Western societies, a strong focus on ‘the bodily part’ of pain still exists today, as many (Western) healthcare professionals are of the opinion that pain needs a bodily onset.
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Unravelling low back pain remains a clinical challenge and the ideas about what can count as proper and necessary judgements are still a topic for debate.
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​Recently, Dorien Goubert and Iris Coppieters obtained their PhD degree at Ghent University, Belgium. Dorien completed her PhD on studies linking peripheral (i.e., muscular) and central aspects of chronic low back pain. The title of her PhD was ‘Peripheral back muscle dysfunctions and central pain mechanisms: an innovative perspective on differences between recurrent and chronic pain’ and you can check out her publications here: https://www.ncbi.nlm.nih.gov/pubmed/?term=Goubert+D%5BAuthor%5D). Iris’ PhD, entitled ‘Relationships between cognitive deficits, central sensitization, and structural brain alterations in patients with chronic idiopathic neck pain, chronic whiplash associated disorders and fibromyalgia. Unravelling differences in underlying mechanisms’ included some of her following publications: https://www.ncbi.nlm.nih.gov/pubmed?term=Coppieters%20I%5BAuthor%5D&cauthor=true&cauthor_uid=24508406 Congratulations to both of them!
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Pain has always been a matter of interest to those involved in rehabilitation and medicine. Decades of research has led to the understanding that pain is an extensive and complex mechanism, influenced by thoughts, emotions, context, previous experiences, perceptions, etc.
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Working in a rehabilitation centre means that you have to deal with pain every day. Actually, it is quite frank to notice that someone’s pain is an everyday part of my job.
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Within the biomedical model, pain is considered a consequence of tissue damage. However, we all know now that a precise biomedical diagnosis cannot be given in the majority of the low back pain (LBP) patients. Enter: the biopsychosocial perspective.
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Musculoskeletal pain is a highly prevalent disorder. People often seek help from a physiotherapist to relieve their pain and related limitations.
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Patient’s pain and disability improvement is an everyday challenge for physiotherapists.
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For centuries chronic pain has been viewed as a solely biomedical issue in the tissues. However, times are changing and we now know that (chronic) pain is a complex construct in which not only physiological factors play a role. In addition, pain is influenced by psychological factors, such as thoughts and feelings, and social factors, for instance judgement and misunderstanding.
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The biomedical model falls short in explaining chronic pain. Although many clinicians have moved on in their thinking and apply a broad biopsychosocial view with regard to chronic pain (patients), the majority of clinicians (including myself) have received a biomedical-focused (undergraduate) training/education.
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It is well established that pain has the function of maintaining the integrity of the body. Pain is an evolutionarily acquired alarm signal of bodily threat and this phylogenetic function is extremely important for survival.
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