Words Matter: The Role of Language in Patient Care   November 6th, 2024
Words have an incredible power to influence our thoughts, emotions, and actions. Whether in healthcare, personal interactions, or professional settings, the language we use can significantly impact outcomes. This blog post explores the profound effects of words. Research has shown that the way information is framed can influence behaviour, change perceptions, and even alter physical sensations like pain.
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The role of oxytocin in chronic pain   November 5th, 2024
Chronic musculoskeletal pain remains a challenging condition to manage, not only because of its physical impact but also due to the significant role psychosocial factors, like stress, play in exacerbating the condition (Kang et al., 2023). Recent research has begun to highlight the potential of oxytocin, a hormone traditionally associated with childbirth and social bonding, in modulating both pain and stress, potentially offering new avenues for chronic pain management (Mekhael et al., 2023).
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An anti-inflammatory lifestyle to alleviate chronic pain   November 4th, 2024
Inflammation is a vital part of the body’s defence mechanism, but its role extends far beyond fighting off infections. It can be linked to a wide range of conditions such as pain, fatigue, cancer, and diabetes. But how does this process contribute to such diverse symptoms?
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The Role of Perceived Injustice in Chronic Pain: What We Know and Why It Matters   November 1st, 2024
When people think about chronic pain, it is often focused on physical symptoms. However, there is a great shift towards a biopsychosocial (compromising biological, psychological and social factors) thinking of pain1 to understand the complete context.
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CONTRADICTORY MESSAGES ABOUT PAIN: WHAT ABOUT PAIN EDUCATION IN CURRENT CURRICULA?   August 30th, 2024
Finding the cause of a patient’s pain complaint can be a real struggle for both the patient and the healthcare provider, especially when the pain is chronic (i.e., lasts longer than three months (1)) and widespread. This struggle often leads to frustration in many patients, as the messages they receive about the cause and treatment of their pain are often contradictory, depending on their healthcare providers (2). Unfortunately, this problem is very common in daily clinical practice.
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Pijn: een expeditie naar interdisciplinair gebied   August 29th, 2024
Nieuw zijn in de wereld van pijnonderzoek, maar zeker wel vol zitten met interesse en motivatie, moedigde mij aan om in de literatuur te duiken rond het onderwerp. Niet enkel in professionele en academische context, maar ook daarbuiten in het dagelijkse leven kreeg mijn leeslijst langzaamaan een andere inhoud. In deze tekst vertel ik de lezer graag meer over mijn meest recente literair avontuur: Pijn: een expeditie naar onbestemd gebied, door Sanne Bloeminck.
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Shifting the Focus: How the European Pain Federation’s Latest Position Paper on Physical Activity for chronic pain and the PECAN Study can Transform Chronic Pain Management After Breast Cancer   August 28th, 2024
Chronic pain is a significant issue that affects millions of people, including those who have survived breast cancer. Traditional treatments often focus on medications, but recently published insights from the European Pain Federation (EFIC) are shifting the spotlight toward physical activity as a primary intervention for chronic pain.
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What’s in a name? Discussion about whiplash associated disorders (WAD)   August 27th, 2024
Whiplash associated disorders (WAD) have been a source of discussion for a long time. Controversy exists between the presence of chronic complaints of the cervical spine and a sustained whiplash trauma with questions about the diagnosis, treatment, and prognosis of whiplash injuries (Yadla S et al, 2008).
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THE INFLUENCE OF CHRONIC STRESS ON CORTISOL LEVELS AND ITS ASSOCIATION WITH CHRONIC PAIN   August 27th, 2024
An introduction to the stress response systems In modern society, we have to deal with daily stressful events challenging our own body and its capabilities1. Think about posting something on Instagram and waiting for that first like, managing a heavy workload with strict deadlines, or worrying about the things you will have to do tomorrow.
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“Are you a catastrophizer?” Understanding the patient perspective on pain catastrophizing   August 26th, 2024
The term "catastrophizing" was first introduced in 1962 by A. Ellis to describe a key factor in emotional dysfunction.1 He defined it as “exaggerating adversities into something far worse than they actually are; seeing things at their worst when they are sometimes relatively minor; and greatly exaggerating the frequency and/or danger of something that you dislike”.
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The social prescription: why do we need to pay attention to the social environment and support of our patients?   July 23rd, 2024
The American College of Lifestyle Medicine identifies social connection as one of the essential pillars of therapeutic lifestyle interventions for treating chronic conditions. This pillar, alongside others such as nutrition, physical activity, stress management, restorative sleep, and the avoidance of risky substances like tobacco and alcohol, plays a crucial role in promoting health.
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Chronic pain: The brain didn’t get the message.   May 31st, 2024
Lisa Feldman Barrett, a well-respected neuroscientist, psychologist and known for her groundbreaking research on emotion, the brain, and the mind, shares some sublime insights in her book “How Emotions are Made.
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The Healing Power of Breath: Exploring Deep Breathing Exercises for Pain Management   May 31st, 2024
In the hustle and bustle of modern life, it's easy to overlook the simple yet profound act of breathing. However, for centuries, cultures around the world have recognized the therapeutic benefits of deep breathing exercises. In this blog post, we delve into the realm of breathwork and its remarkable potential in managing pain, offering a holistic approach to well-being that harnesses the power of the breath.
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Phenotyping nociceptive, neuropathic, and nociplastic pain in the past, present and future   May 30th, 2024
​Do you consider all myofascial pain to be nociceptive pain? Do you consider all carpal tunnel syndrome and/or all post-chemotherapy pain pure neuropathic pain? Do you explain pain in the same way to patients with nociceptive, neuropathic, and nociceptive pain?1 If you respond positively to at least one of these questions, we invite you to continue reading. You see, phenotyping persistent pain into predominantly nociceptive, neuropathic or nociplastic pain is not that straightforward and potentially, pain phenotyping has clinical implications.
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A paradigm shift from a tissue- and disease-based approach towards multimodal lifestyle interventions for chronic pain   May 29th, 2024
It’s been two decades since we started studying the role of central nervous and immune systems in patients with chronic pain. Back then, we could not imagine what massive, global impact pain science would have on our profession and healthcare for patients suffering from pain in general.
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Let’s connect:
The importance of person-centered communication in pain management   April 11th, 2024
Pain is a complex and subjective experience that requires a person-centered approach in its management. In the realm of healthcare, person-centered communication is often underestimated in the management of pain. It extends beyond the mere collection of information: it serves as a gateway to understanding and a crucial alliance between the healthcare provider and the patient.
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Does pain intensity still serve as gold standard to measure pain?   April 11th, 2024
The individual feeling of suffering and the personal translation of that experience into a patient’s daily living is the signature of the heterogenous subjectivity of chronic pain. By definition, a painful experience is always a personal interpretation. Yet, despite this knowledge, clinicians, pain physicians and clinical researchers still often use oversimplifications and minimizations of a patient’s health status through unidimensional constructs such as pain intensity.
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Left out in the cold – hallmarks of nociplastic pain yet remaining unclassifiable   April 10th, 2024
Nociplastic pain may not be characterized only by sensory hypersensitivity. What about persistent, widespread pain with numbness and sensory loss or hypo-sensitivity? How do we classify people with no allodynia to light touch, stroking nor hot/cold applied to the skin, no hyperpathia nor temporal summation but with widespread, unpredictable pain, perhaps some weakness, fatigue, sleep dysfunction and/or cognitive difficulties?
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The interplay between breathing and experienced symptoms in cancer patients   April 9th, 2024
Patients with cancer experience acute and chronic symptoms such as pain, fatigue, insomnia, anxiety, depression and cognitive impairment. The co-occurence of these symptoms has been described as the symptom cluster, which is negatively associated with quality of life.
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Unpacking the Impact of Social Support on Physical Activity in Cancer Survivors   February 14th, 2024
One in four cancer survivors will experience persistent pain after ending cancer treatment. In our exploration of chronic pain among cancer survivors, evidence shows time and time again that physical activity plays a vital role in alleviating symptoms and improving quality of life.
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Pain management around the clock: the significance of sleep   February 12th, 2024
Our work and lifestyle choices are contributing to the normalization of poor sleep1,2. This is in contrast with the extensive research linking good quality sleep with positive mood, learning, memory consolidation, and physical recovery. Conversely, poor sleep leads to important consequences for our health1.
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Does my body need protection, right here, right now?   February 10th, 2024
​Before delving into the topic of interest for this post, I would first like you to take a look at the image of the two tables. To most people, this image depicts two tables of which one appears longer and thinner than the other. However, the truth is that the two tables are of the exact same size, both in terms of length and width.
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Let’s talk about sex!   December 4th, 2023
Let’s talk about sex, baby (1). Or maybe not? Let’s talk about gender! To talk about gender, I will start with some definitions so we speak the same language.
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​Exploring the link between chronic tinnitus and central sensitization.   October 9th, 2023
Do you sometimes hear a ringing in your ears after a night out or a loud concert? If so, you're not alone. This phenomenon is called tinnitus, and it affects a significant number of people worldwide. In fact, about 10% of the population experiences chronic tinnitus (present for more than 3 months) (1). However, despite the high prevalence of tinnitus, we still have a lot to learn about its causes and effective treatments.
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A new chronic pain pandemic on the horizon? Long COVID affects millions of people   August 20th, 2023
​In 2020, the world was battling COVID-19 and many countries introduced lockdowns or restrictive measures. Three years later, such lockdowns and restrictive measures are luckily not required anymore to protect us from COVID-19, but did you know that millions of people (65 – 144 million) are still living in lockdown or under restrictive measures as a result of their COVID-19 infection? These people suffer from long COVID.
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The role of systemic inflammation in chronic musculoskeletal conditions   August 17th, 2023
Several chronic musculoskeletal conditions are characterized by pain and changes in connective tissue. Treatment has traditionally focused on regional processes. Frequently, it is thought the injuries arise from a local origin. Herein, local inflammation initiates mechanisms to drive adaptation and repair.
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​Words matter! Language to use versus to avoid in the context of acute pain management in children   June 8th, 2023
Acute pain is “a normal, predicted physiological response and experience to a noxious chemical, thermal or mechanical stimulus associated with acute illness, trauma or surgery”.1,2 Acute pain is usually sudden in onset, limited in time, and motivates behavioral responses to avoid actual or potential tissue damage.
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​Individualized care in chronic pain research   June 7th, 2023
Chronic pain is defined as pain that persists for more than three months and currently affects over 20% of people worldwide, making it the leading cause of disability and disease. Despite its prevalence, optimal treatment for chronic pain is still lacking.
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​Cracking the Code of Chronic Cancer Pain: The Immune System and Your Inner Clock   June 6th, 2023
Although there are more cancer survivors due to better treatment options, cancer survivors still face many challenges including chronic pain1,2. According to recent studies, approximately 40% of cancer survivors suffer from chronic pain which significantly impacts their quality of life1,3,4. Nowadays, scientists are investigating the underlying mechanisms so they can better understand the causes of chronic pain in order to improve pain management.
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Culture matters!!!   March 31st, 2023
Chronic pain is a common, difficult, and distressing problem that significantly impacts society and individuals. The cause of chronic pain is a complex interaction between biological, psychological, and social factors. Understanding chronic pain in the context of a bio-psycho-social model will help to develop treatment plans and prevention strategies.
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Have you ever felt your stomach growl? Your head pound? Your heart race? Your palms sweat?   March 30th, 2023
If so, do you know how you are able to feel these feels? To notice these feelings you need the help of an important sense called interoception. The word interoception might not sound very sexy, but this sense is really important. It has a huge influence on many areas of our lives like self-regulation, mental health and social connection1.
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Breaking the Cycle of Misinformation: Health Literacy's Role in Managing Chronic Pain   March 28th, 2023
Health literacy refers to a person's ability to access, understand, and use information related to health(care). This includes the ability to read and understand health information, to navigate healthcare systems, to communicate effectively with healthcare providers, and to apply the information to make decisions about one's own health.
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An Interdisciplinary Multimodal Integrative Healthcare Program For Somatic Symptom Disorder With Predominant Spinal Pain   March 27th, 2023
Somatic symptom disorders (SSD) are characterized by an excessive focus on somatic symptoms that causes significant emotional distress and a disruption of daily life. In addition, individuals suffering from a SSD often have excessive thoughts, feelings and/or behaviors related to these somatic symptoms and associated health concerns [1].
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Sleep and pain, a vicious cycle   March 24th, 2023
Are you experiencing pain? If yes, consider asking the next question: how well did you sleep last night?
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Don’t forget the practical context and the people involved in the target culture during the cultural adaptation of pain neuroscience education   March 23rd, 2023
Around six years ago, I went to Kisumu, Kenya for an International Aid and Development program (IAD). My landlord there shared an educational story in the field of IAD. “Once upon a time”, she said, “an American engineer found out that women in Kisumu needed to walk for hours to get fresh water and carry that water back home.
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Renaming pain catastrophizing: 
what do patients think about this?   March 22nd, 2023
Pain catastrophizing: as a clinician and/or researcher in the field of pain, this term may sound familiar to you. Pain catastrophizing is often broadly conceived as an exaggerated mental mindset during painful experiences (1). It has been identified as an important and consistent psychosocial predictor of almost every significant pain-related outcome.
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The impact of weather conditions on pain experiences   December 29th, 2022
It is that time of the year again… The leaves have fallen from the trees, days are short, and the weather outside is freezing cold. While we are spending our time sitting on the couch under a nice warm blanket, we daydream about sunny beaches, summer bars, and flip flops. Typically during winter, we have the feeling that our neck or low back is hurting more. Our joints are feeling stiff and we have less motivation to exercise. Health professionals experience that their patients with chronic musculoskeletal pain are feeling worse during bad weather. But is this only a feeling? Or does the weather actually influence our pain experiences?
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Introducing the newly proposed Fit-for-Purpose model for chronic low back pain   December 28th, 2022
Just published in Physical Therapy in November 2022 is a proposed new model for addressing the problem of chronic low back pain (CLBP) in physiotherapy: The Fit-for-Purpose model (Wand et al., 2022).
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My Rotator Cuff Tear may have serious consequences on my life! - Are injury perceptions a prognostic factor for the outcome pre and post Rotator Cuff Repair?   November 2nd, 2022
Illness perceptions - or in our case injury perceptions - are defined as organized representations patients have about their condition (injury). Health threats may elicit these cognitive and emotional representations and further influence a patient’s behavior. Cognitive representations are central mechanisms to control danger and emotional representations are central mechanisms to control fear. If the central neural system (CNS) decides a person is in danger, pain may be processed. Pain is a neurophysiological phenomenon and one of the most powerful and sophisticated constructs from the human’s sensitive CNS to protect us from danger.
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The CIM Project: Together We Bring Team Fibromyalgia to the Foot of the Highest Mountain in the World   November 2nd, 2022
CIM Project Is is a non-profit organization project promoted by technical sports personnel from mountain activities and health personnel, who work together to promote the development and practice of physical activity and sports, aimed at the inclusion of people with disabilities, chronicity or in the aging process, as well as different groups at risk of social exclusion, such as migrants, people with low economic resources, etc. for prevention, health promotion and therapeutic intervention in the field of nature and mountains.
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Impact of technology and health-related effects of the COVID-19 Pandemic on elderly people.   November 1st, 2022
The COVID-19 pandemic, decreed by the World Health Organisation on 11th March 2020, has had a dramatic impact on the health of the population, especially the elderly people. Lockdowns and mobility restrictions became a necessary measure to stop the spread of the virus and resulted in a drastic sudden change in everyone’s lifestyle and a great influence on the diet, exercise, social activities, and mental health.
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The challenge of physical activity: Overcoming the hurdles   October 31st, 2022
Guidelines on pain management for patients with chronic pain all promote physical activity and exercise as part of treatment strategies. However, chronic pain is a very broad term and it encompasses many different populations. Each individual will have a different experience of their pain and will have different influencing factors.
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Information about Low Back Pain on Brazilian official Websites do not follow the current guidelines.   July 12th, 2022
The internet presents much health information that is available to anyone with easy access. It has become the primary source for patients and families to find information about their clinical condition including symptoms, preventive methods and treatment options [1].
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SYSTEMIC CYTOKINE LEVEL DIFFERENCES IN PATIENTS WITH CHRONIC MUSCULOSKELETAL SPINAL PAIN COMPARED TO HEALTHY CONTROLS AND ITS ASSOCIATION WITH PAIN SEVERITY   July 11th, 2022
Chronic musculoskeletal pain is one of the most common chronic pain conditions and can be described as pain arising from muscles, tendons, joints and ligaments, which has been present for at least three months [1, 2]. Chronic spinal pain (CSP) is the most frequent form of chronic musculoskeletal pain and is situated in the cervical, thoracic or lumbar region [3-8].
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Could a “waste management problem” be involved in chronic pain?   July 10th, 2022
Distinguishing normal from abnormal when interpreting brain scans can be challenging, especially as a novice. One of the patterns you might notice is that certain brains have enlarged perivascular spaces. These spaces, also referred to as “Virchow-Robin” spaces, are generally considered normal.
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Pain and opioid use in cancer survivors: should we account for perceived injustice?   July 9th, 2022
Pain is one of the most disabling and occurring symptoms in cancer survivors (1). About 5-10% of people surviving cancer develop chronic severe pain, which is up to 40% in the early post-treatment period of cancer (2). Up to now, pain medication is still the recommended standard treatment for cancer-related pain (3).
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A supersystem within the human body as a framework for associations between the nervous, endocrine, and immune system   May 24th, 2022
A human being can be considered as an open, living adaptive system that aims to adapt to the environment and survival. Like every system, it includes nested subsystems, that function as component parts. A system is defined by a set of components constituting a whole within which each component interacts with or is related to at least one other component. All these components serve a common objective. Some (sub)systems of the human body are the nervous, endocrine, and immune system, and they function interdependently. In the following, I will explain how these systems work, in what way these specific systems function interdependently, and why this is different for each individual.
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An eHealth application for perioperative pain neuroscience education: introducing the B²EARS-APP   May 23rd, 2022
In just two years, COVID-19 has broadly impacted and disrupted usual health care, often leading to the postponement of non-urgent health care practices [1]. Despite these and other negative consequences, the pandemic is also responsible for an increase in the use of tele- and eHealth applications. Such applications use the potential of smartphones, computers, and the internet to allow for remote patient treatment and monitoring [2, 3]. Specifically, patient education via e-learning seems to be a cost-effective and easy-to-implement use of such eHealth applications. In fact, studies introducing eHealth applications as a way to further inform and educate patients have already been completed successfully [4-6]. Though eHealth interventions for perioperative education in patients undergoing lumbar surgery are still evolving, early evidence is supportive of such applications [7].
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Chronic pain and aging: How we face it?   May 22nd, 2022
Chronic pain is one of the major concerns worldwide. Chronic pain in the elderly can be a challenging situation for clinicians not just for the complexity of chronic pain itself but also for the comorbidities that can be present at this age range.
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Treating persistent pain after breast cancer: practice gaps and future directions   May 22nd, 2022
A new international, multidisciplinary collaborative has been formed with world-leading experts in pain science education, (cancer) pain, and oncological rehabilitation: Pain Education after CANcer.
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Epigenetics and the autonomic nervous system: what is their role in chronic pain?   May 21st, 2022
The word “epigenetics” can be split in “epi” and “genetics” - “epi” means on and “genetics” refers to DNA - so epigenetics refers to molecules that are attached on our DNA. These molecules change the readability of the manual of our body and thus impact all body functions. What is interesting about epigenetics, is that it can be influenced by several factors, for example lifestyle and environmental factors.
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How to taper patients with chronic pain off of opioids? Pain education and a multi-/transdisciplinary approach!   May 21st, 2022
Chronic pain is a health problem that is affecting about 20 percent of the European population (Van Hecke, Torrance & Smith, 2013). Considering the cost of chronic pain, we should take into account the public health care expenditure but also costs caused by loss of productivity (Boonen, 2005). According to the ‘NHG standard: pain’ (De Jong et al., 2018) for the pharmacological treatment of pain, the first step is the use of a non-opioid analgesic, including paracetamol, followed by the use of non-steroidal anti-inflammatory drugs (NSAIDs). If this does not work (sufficiently), step two is the prescription of a weak opioid analgesic such as tramadol.
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Kids & needles: Things to consider and tips & tricks for parents and clinicians   May 20th, 2022
For many children, needle procedures can be a painful and distressing experience. Such negative experiences can further develop into fear of needles (McMurtry et al., 2015) with a possibility of adverse consequences, such as health care avoidance behavior and vaccine hesitancy. Given the current combat with the COVID-19 pandemic and global vaccination campaign, which since recently also includes children, reducing fear of needles is important to consider and manage (Love and Love, 2021).
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The convergent validity of the central sensitization inventory in chronic whiplash associated disorders   March 7th, 2022
Whiplash associated disorders remain the most common injury associated with motor vehicle accidents and a major cause of disability (Ritchie et al, 2013). The consequences for people suffering a whiplash injury can be substantial with an evidential impact on their daily living (Campbell et al, 2018). Still, the exact pathophysiology is not entirely clear.
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Can patients with chronic fatigue syndrome assess their physical activity level through self-report?   March 4th, 2022
Physical activity levels can be assessed by two main types of measures: objective or subjective measures (Prince et al., 2008). Each measure has its own strengths and weaknesses confirming the need for the examination of their psychometric properties (Prince et al., 2008; Hills et al., 2014).
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Is knee osteoarthritis always chronic secondary pain?   March 2nd, 2022
Chronic pain, chronic primary pain, chronic secondary musculoskeletal pain, chronic postsurgical or posttraumatic pain,… What is the difference between these terms and which one contains knee osteoarthritis pain?
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The lived experience – qualitative research in the field of chronic pain   March 1st, 2022
There is something tempting about numbers and figures. They are ‘clear’, we believe them to be straightforward and helpful in untangling our complex world. In healthcare, both clinical and in research, we love quantitative measures.
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Pain memories: Something to consider in People with Haemophilia (PwH)   February 28th, 2022
Haemophilia is a genetic disorder which is characterized by recurrent joint bleedings. Consequently, the majority of adult PwH suffer from very painful and invalidating hemophilic arthropathy. Although the complexity of joint pain has been studied in several chronic joint pain conditions, until present only very limited research has been done on joint pain within PwH. As a result, developing effective treatments for chronic pain in PwH has been clearly identified as a priority for research in bleeding disorders.
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How to exercise at home? Creating an individual strength and stretching workout to perform in a home environment   January 18th, 2022
It is a challenging time to stay active and to adapt our normal activities due to the COVID-19 pandemic. As working out in group or with a supervisor is not always possible, exercises at home gain popularity. We have never been walking so much as during the past year, as it was one of the only possibilities to have some social contact.
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​Does education hinder learning in patients with chronic pain? Considerations on prediction errors, learning, and expectancy violation   September 6th, 2021
Every time we experience something new, we are in the position of learning and memorising the new experience. Learning depends on several factors, including motivation, rewards, self-reflection, saliency, and repetition. One additional important aspect that seems crucial for learning is the presence of a prediction error.
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Submit your abstract for Pain Science in Motion IV Maastricht 2022, the only pain congress in the world to focus on PhD candidates!   July 15th, 2021

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Watch the symposium Pain & the Brain Across the Lifespan for free here   July 14th, 2021

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Obesity hurts: should we consider weight management within pain management?   July 9th, 2021
Before we were all held captive by the COVID-19 pandemic, another pandemic was (and still is) dominating our world. With high prevalence rates, some consider obesity the ‘real’ pandemic of the 21st century.
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Effects of a training program on the autonomic nervous system and innate immune response in autoimmune disease/spondyloarthritis   July 8th, 2021
Excessive or persistent proinflammatory cytokine production plays a central role in autoimmune diseases. Research by Kox M. et al. (1,2) evaluated the effects of a training program on the autonomic nervous system (ANS) and innate immune response.
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Quantitative sensory testing: What’s in a name?   May 4th, 2021
Over the past decades mechanism-based approach to pain management has been progressively underlined to achieve clinically meaningful improvements in pain outcomes.
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Chronic pain during COVID-19: the consequences of social isolation on pain. update   April 30th, 2021
COVID-19, a highly infectious disease that was first reported in Wuhan in China in December 2019, has definitely changed our behaviour. COVID-19 is caused by the SARS-CoV-2 virus.
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Should we start targeting the brain’s insula in the treatment of fibromyalgia?   April 27th, 2021
​In Europe, 1 in 5 people suffer from chronic pain, which means that we all know someone who is struggling with chronic pain complaints. This pain can be located in a specific region, such as migraine or chronic low back pain, but can also occur all over the body as is the case in fibromyalgia.
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Time to Change Habits. Physical Activity and the Transtheoretical Model of Behavioral Change   April 22nd, 2021
Overwhelming evidence proves the notion that reduction in daily physical activity is a risk factor behind several chronic diseases (Lacombe et al., 2019) and that individuals who are more physically active have a lower risk for the development of chronic pain (Landmark et al., 2011).
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Chronic pain as a hallmark of haemophilia. Remarkable, but true.   April 19th, 2021
​To date thousands of rare diseases have been described in medical literature and still every day researchers worldwide are working to discover and better understand new unique diseases.
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The reason why I disappoint my parents   April 15th, 2021
​“Can you have a look at my back when you visit us tomorrow?” A friend sends me a text on Saturday. My phone rings, it’s my mother calling: “My ankle hurts. I am already unable to walk normally for the whole week now. What do you think it is?”
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Culture-sensitive Pain Neuroscience Education: a means for wider pain therapy access   April 12th, 2021
Pain Neuroscience Education (PNE) is a method of educating patients about the neurophysiology of pain. It aims to re-conceptualize pain from an indicator of damage to an interpretation of input signals by the brain and nervous system.
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Differences in pain processing between patients that recover from a whiplash injury and those developing chronic pain are already present in the early phase   February 2nd, 2021
n the acute phase after whiplash injury, most patients report pain and disability. Usually, these complaints reduce gradually within the first three months (1). Some patients continue to experience pain and disability and develop chronic Whiplash Associated Disorders (WAD).
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The transition from acute to chronic non-specific low back pain: fear avoidance vs endurance   January 28th, 2021
It is important to increase our understanding of the mechanisms underlying the transition from acute to chronic non-specific low back pain (NSLBP) to improve treatments for NSLBP and individual treatment decisions in an early phase of low back pain and ultimately to prevent the development of chronic NSLBP.
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Improving care by integrating sociocultural factors within physiotherapy practice; 
the CuPiD project   January 20th, 2021
Non-specific musculoskeletal pain is highly prevalent, with point estimations up to 51% in Europe1,2. Percentages are higher in women than in men3 and most commonly represent pain in the lower back, shoulder, neck, hip or knee.
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The forest, the trees and the IASP clinical criteria for nociplastic pain!   December 31st, 2020
Following new approaches to chronic pain management, mechanism-based therapy is considered more effective than diagnosis-based treatment (Levin, 2004, Nijs et al., 2019a). Pain phenotyping is a challenging issue that seems to contribute to the provision of individualized rehabilitation and patient-centered care (Nijs et al., 2021).
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Chronic pain during COVID-19: the consequences of social isolation on pain.   December 2nd, 2020
COVID-19, a highly infectious disease that was first reported in Wuhan in China in December 2019, has definitely changed our behaviour. COVID-19 is caused by the SARS-CoV-2 virus. The World Health Organisation has declared COVID-19 as a pandemic on March 11th, 2020 due to the rapid increase in number of confirmed cases (Wang et al. 2020).
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Expectations and distraction influence pain and (pain) treatment   December 1st, 2020
The International Association for the Study of Pain (IASP) defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (1). Pain is considered as a warning system for tissue damage.
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A mechanism-based approach for the management of pain?   December 1st, 2020
It is well known that pain is a complex phenomenon with challenging treatment. The Department of Health and Human Services recently published a National Pain Strategy, highlighting the insufficient training in pain assessment and treatment for many clinicians.
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​Pain mechanisms: is consensus on terminology and definition possible?   September 23rd, 2020
There is no doubt that musculoskeletal pain is a complex multidimensional phenomenon. At present, musculoskeletal pain diagnosis is based primarily on signs and symptoms, sometimes combined with evidence of disease, structural damage, or injury.
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Can we train the chemo-brain?   September 23rd, 2020
“When I meet a friend on the street, I can’t even remember her name.”
 “Where did I leave my keys?”
 “Oh, darn I forgot my doctor’s appointment today!”
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​Trait characteristics and pre-morbid contexts may contribute to the development of central sensitisation in chronic low back pain: results from a mixed methods study.   September 23rd, 2020
At the start of this research series, we were asking the clinical question as to why central sensitisation (CS) develops in some people and not in others. Is it something to do with their personal characteristics of sensitivity? Here, I want to outline what we did to begin investigating this and summarise for you the proposals we came up with.
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Moderator, Mediator, Predictor or Prognostic factor – Which factor fits my Research Question?   September 23rd, 2020
Despite the long history of usage in medicine, psychology, sociology and other sciences, the terms “moderator”, “mediator”, “predictor” and “prognostic factor” still seem to elicit discussions among researchers. Several authors have described how these terms are used interchangeably, neglecting important careful handling
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SCARED BEFORE SURGERY? YOUR BELIEFS MIGHT HURT YOU!   July 15th, 2020
By now, it is a well-known fact that low back pain is a very common condition disabling a lot of people during the span of their lives, as well as that many of these people have to undergo lumbar surgery at one point or another.
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A need of subgroups within the large group of people with (chronic) low back pain   June 10th, 2020
As a physiotherapist, I see many patients with low back pain (LBP). The type of intervention varies from patient to patient, and moderate treatment effects are observed. LBP is a well-known health problem with high socioeconomic costs (Hoy et al., 2012).
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Self-efficacy when physical therapy consults are discharged? How do patients with chronic pain deal with it?   May 11th, 2020
Self‐efficacy (SE) is defined as an individual's confidence or belief in their ability to achieve behavioral goals in a specific field (Bandura, 1977). In the context of chronic pain SE refers to beliefs held by people with chronic pain that are able to carry out certain activities, even when experiencing pain.
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The impact of parental responses upon child pain behavior and the moderating role of parental distress   May 10th, 2020
Just imagine, going to a medical practice with your child for an injection. Or for those of you that are not a parent yet, go back in time for a second and think of a moment you remember going for a puncture procedure yourself with your mother or father.
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Agrippa study; an additional strategy for self-management in chronic pain patients   May 10th, 2020
For many patients, ongoing or recurrent pain severely impacts their physical, social and mental health, as it interrupts ongoing activities and thereby continuously interferes with daily life functioning.
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Food for thought: “Should we consider nutrition in chronic pain management?”   April 10th, 2020
​For a while now, (healthy) nutrition is a major topic of interest in society. Every day there seems to be a new superfood-hype or need-to-follow diet. All these options can be overwhelming, making it difficult for people to see the wood for the trees. Also within the chronic pain field, the need for clear nutritional guidelines is increasing, with both patients and clinicians asking for specific advise in this area.
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A new decennium… But what do we know about whiplash? Twenty whiplash facts to start 2020   January 14th, 2020
The term “whiplash” is given to the acceleration-deceleration mechanism of energy transfer to the neck and head at impact. It may result from rear-end or side-impact motor vehicle collisions, but can also occur during sport (horse riding, diving, snowboarding) and other mishaps.
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Occupational performance and chronic pain   January 14th, 2020
‘Occupational therapy is a client-centred health profession concerned with promoting health and wellbeing through occupation’ (WFOT, 2012). It is based on the assumption that there is a relationship between occupation, health, and wellbeing and that engagement in occupations can enhance, maintain or restore health (Le Granse et al., 2017).
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Do you consider using heart rate variability training in your clinical practice?   January 14th, 2020
A normal healthy heart does not tick evenly like a metronome. We know that the normal resting rhythm of the heart is highly variable rather than monotonously regular.
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Pain neuroscience education in the digital era: do we still need therapists?   January 14th, 2020
In this digital era, healthcare services are more and more evolving towards eHealth applications. Especially for educational and behavioral interventions digital applications are becoming very popular in clinical practice but also in research.
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Meta-analyse effecten van pijneducatie voor patiënten met chronische musculoskeletale pijn   December 14th, 2019
De prevalentie van chronische musculoskeletale pijn (CMP) wordt geschat op 20% van alle volwassenen wereldwijd. Verder is CMP één van de meest gerapporteerde redenen om medische zorg te zoeken. Daarenboven blijkt bijvoorbeeld chronische lage rugpijn op globale schaal de belangrijkste reden te zijn voor leven met functieverlies.
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Treatment in different contexts, does it matter?   December 13th, 2019
Did you ever wonder why a specific treatment does not always have the same effect in one person compared to another despite having the same problem?
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Infectious Adverse Effects after Acupuncture   December 12th, 2019
Acupuncture is commonly used for pain control, but doubts about its effectiveness and safety remain. Serious adverse effects continue to be reported.
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Online Symposium Kankerpijn in Beweging   November 13th, 2019
Symposium Pijn na Kanker vindt plaats in Brussels health campus Jette (Zaterdag 10 oktober 2020)
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Meet ZORA! Robot distraction for children with cancer and chronic immune deficiencies.   November 12th, 2019
Did you know ZORA already? ZORA is a humanoid robot, which means she is designed to appear human characteristics, such as movements and appearance. Humanoid robots can be programmed to work with people, and to communicate verbally and nonverbally.
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Where is the field of pain going? Reflections on the last EFIC congress   November 12th, 2019
Big congresses typically have so many lectures and sessions, often in parallel, that everybody is sort of living a different and personal experience – a bit like visiting one same region of the world, but planning the journey differently, taking different paths. What follows here in the blogpost, it is clearly just my experience, but anyway, here you are.
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Stress and pain perception: a complex phenomenon   October 1st, 2019
The interaction between stress and pain perception is complex. Stress has undoubtedly impact on pain perception.
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​Pain Neuroscience Education: shades of grey   July 15th, 2019
The efficacy of Pain Neuroscience Education (PNE), the explanation of pain to patients with (long-term) pain, has been studied since 2002 (Moseley, 2002).
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Endogenous analgesia in children with functional abdominal pain disorders   July 10th, 2019
A vlog by Prof. Roselien Pas
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Save the Date! Pain Science in Motion IV will be held in Maastricht, the Netherlands (19-20 May 2022)   May 28th, 2019
Save the Date! Pain Science in Motion IV will be held in Maastricht, the Netherlands (27-28 May 2021)
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Explaining Pain Following Cancer   May 18th, 2019
A vlog by Prof. Jo Nijs
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What patients possibly learn while ‘under treatment’; some thoughts on the importance of patients perceptions about low back (in)vulnerability’   May 16th, 2019
Some days ago, my car made an uncomfortable sound and I immediately thought ‘something is wrong with my right front wheel’. I went to the garage and told them what, in my opinion, was wrong with my car.
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Movement-evoked pain: a new way of understanding (chronic) pain?   May 15th, 2019
Physical activity is known to play an important key role in the treatment of pain conditions and is an effective strategy to relieve pain and improve level of functioning in daily activities in various chronic musculoskeletal pain disorders (Daenen, et al., 2015).
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Nutrition and chronic post-cancer pain: Is nutrition the missing piece of the puzzle?   April 8th, 2019
The development of chronic pain is the one of the most seen sequelae in the cancer survivor population (Leysen et al., 2017). But despite that, it is an entity which is poorly studied and comprehended (Burton et al., 2007).
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One world, one education?   April 7th, 2019
Increasing research all over the world is indicating the importance of giving pain neuroscience education to chronic pain patients (Malfliet et al. 2018). Results have indicated an increase in the level of knowledge of the patient and a decrease of in the level of perceived threat, consequently increasing the quality of life.
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“To conquer pain, retrain the brain.” Pain Neuroscience Education in Breast Cancer Patients   April 6th, 2019
Breast cancer is the most frequent malignancy among women worldwide. Despite the high incidence in Western countries, an increase in survival and life expectancy has been observed due to the ongoing improvement of detection method accuracy, early diagnosis and breast cancer treatment (Ferlay et aL., 2015).
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Control over spinal nociception can be learned   April 5th, 2019
There is growing evidence that a state of heightened sensitivity of central pain processing pathways is present in chronic pain patients. Hyperexcitability at the spinal level can be assessed by experimentally inducing a nociceptive flexion reflex (NFR) of the lower limb.
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Brazil and Belgium combining forces to improve exercise prescription for patients with chronic pain? Delphi-study to be launched!   January 30th, 2019
Chronic musculoskeletal pain is one of the conditions responsible for the increase in the number of years lived with disability, absenteeism and health care costs in the world (Andrew et al. 2014, G. B. D 2017).
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Subgrouping patients with chronic whiplash-associated disorders; a way of improving the effect of our therapy?   January 30th, 2019
Whiplash associated disorders (WAD) is among the most common accident-related disorders (about 300 per 10.000 inhabitants in western countries) that have extensive consequences for patients, healthcare services and insurance companies (Tournier et al. 2016).
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The value of electroencephalography for the study of the ‘low back pain brain’.   December 2nd, 2018
“Pain is in the brain” is no longer a novel statement in the field of pain research, but can be regarded as one of the main pillars of most recent thinking models about pain in the last decades.
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Pain in Motion at the World Congress on Pain in Boston, Massachusetts, USA.   December 2nd, 2018
The World Congress on Pain 2018, organized by the International Association for the Study of Pain (IASP) was held in Boston, Massachusetts, USA. This meeting focused on sharing new developments in pain research, treatment, and education.
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Knee osteoarthritis: one size rarely fits all   December 1st, 2018
Successfully alleviating pain in patients with knee osteoarthritis (OA) or in patients with persisting pain after a total knee replacement (TKR) remains a huge challenge.
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Sleep regulation: an important issue?   November 29th, 2018
Sleep problems are frequently seen in several chronic pain populations.
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INVITED BLOGPOST: NECK PAIN AND CENTRAL SENSITIZATION: WHERE ARE WE HEADING?   October 5th, 2018
Neck pain represents one of the most frequent musculoskeletal disorders, with a huge impact in terms of health-care costs and it is the fourth leading cause of disability.
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Journal of Clinical Medicine Special Issue "Rehabilitation for Persistent Pain Across the Lifespan": call for submissions now open!   October 4th, 2018
The area of rehabilitation research for patients having persistent pain is on the move. The rapid growth in pain science has inspired rehabilitation clinicians and researchers around the globe.
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INVITED BLOGPOST: The clinical reasoning process in randomized clinical trials with patients with non-specific neck pain is incomplete   October 4th, 2018
For effective treatment of non-specific neck pain, physiotherapists should be able to rely on the evidence from scientific research. However, scientific research evidence is poorly integrated in physiotherapy. One possible cause for this poor integration is that RCTs do not reflect “the real world” of physiotherapy clinical reasoning.
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Sex Differences in Neuroimmunity and Pain   October 3rd, 2018
Sex differences in pain have been a topic of increased interest in recent years. An expansive body of literature in this area clearly suggests that men and women differ in their response to pain. Controlled laboratory studies have revealed overwhelming evidence for increased pain sensitivity, higher pain ratings and lower pain tolerance of female participants compared with males, although the size of the differences were modest and not always statistically significant (Rosen et al., 2017).
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When is an individual ‘sensitive’ versus ‘sensitised’?   July 4th, 2018
The following blog will discuss the difference between ‘sensitivity’ and ‘sensitization’ and how this might relate to central sensitization pain.
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​Was je erbij? Een geweldig Pain in Motion Symposium in Antwerpen!   June 26th, 2018
Het zonnetje schijnt en de zaal is vol! Ondanks alle verleidingen buiten is er aan het mooie bankgebouw van BNP Paribas Fortis aan de Meir een grote groep kinesitherapeuten/fysiotherapeuten, artsen, afgevaardigden van patiëntenverenigingen en onderzoekers samen gekomen om de laatste inzichten over pijnrevalidatie met elkaar te delen.
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Shoulders to Shoulder: Need for shared decision making in rotator cuff treatment!   June 18th, 2018
Although evidence on psychosocial factors affecting the prognosis after rotator cuff repairs is scarce, a recent systematic review (Coronado et al., 2018) reported that preoperative patient expectation is an important predictor of patient-reported outcomes in patients after rotator cuff surgery.
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Save the date: Pain Science in Motion III in Savona, Italy   June 18th, 2018
JOIN US AT PAIN SCIENCE IN MOTION! May 31 – June 2, 2019 in Savona, Italy
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PAIN, MIND & MOVEMENT: APPLYING SCIENCE TO THE CLINIC SATELLITE MEETING OF THE 17TH WORLD CONGRESS ON PAIN   May 4th, 2018
The scientific committee is proud to announce the program for the Pain, Mind & Movement ‘Applying Science to the Clinic’ Satellite Meeting of the 17th World Congress on Pain.
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Where am I in the central sensitization process? It is not just a matter of time; it is time to take action!   May 3rd, 2018
Central sensitization is an ongoing process in which duration might affect its reversibility.
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Associations between central sensitization and cognitive behavioral factors in chronic low back pain   May 2nd, 2018
​Chronic low back pain (CLBP) is a major problem in today’s society, and often no specific medical cause can be found for the patient’s complaints.
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Call for clinical workshops & oral presentations at the Pain, Mind & Movement: Applying science to the clinic Satellite Meeting of the 17th World Congress on Pain   March 16th, 2018
The scientific committee of the Pain, Mind & Movement: Applying Science to the Clinic satellite meeting welcomes submissions for oral presentations and clinical workshops.
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Symposium Motion in Pain   March 12th, 2018
Verschillende sprekers geven een antwoord op relevante vragen omtrent pijn bij bewegen waar clinici, therapeuten en onderzoekers mee worstelen. Symposion "Motion in Pain", 30 mei 2018 @ Auditorium Hélène Fourment.
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The invisible injuries: Post-Concussion Syndrome VS. Whiplash Associated Disorder   March 7th, 2018
On Thursday January 18th, I was looking at the newspaper and the latest news sport header read: “football career ends after concussion: ‘Good guidance’ was missing”.
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Chronic pain management – What is the role of the occupational therapist?   March 1st, 2018
This is a question that all patients, the multidisciplinary rehabilitation team and more importantly all occupational therapists should ask.
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Are there opportunities for hypnosis and other forms of complementary medicine in chronic pain?   January 24th, 2018
About 20% of the European population will tell you they do experience chronic pain every day (Breivik et al., 2006).
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Acupuncture Analgesia and Chronic Whiplash   January 18th, 2018
An acupuncture treatment can reduce pain sensitivity in patients with chronic whiplash associated disorders (WAD). But it has been hypothesized that many of the experimental results in acupuncture research could be interpreted as stress-induced analgesia.
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Inaugural lecture Enrique Lluch Girbes as visiting professor at the Vrije Universiteit Brussel   December 12th, 2017
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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INVITED BLOGPOST: A change of perspective: altered muscle activation in the ACL deficient individual   December 12th, 2017
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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Differences between recurrent and chronic pain and their clinical implications   December 11th, 2017
In low back pain there are clear clinical differences seen between recurrent and chronic low back pain patients.
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INVITED BLOGPOST: Mindfulness Training for the Treatment of Chronic Back Pain   December 8th, 2017
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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Invited blogpost: The efficacy of neurodynamics or neural mobilisation for nerve-related musculoskeletal conditions   November 7th, 2017
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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Can you as a clinician recognize the dominance of central sensitization in patients with knee osteoarthritis pain in your routine clinical practice?   November 6th, 2017
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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Who is at risk of developing central sensitisation? Our systematic review.   November 2nd, 2017
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 dark side of exercise: when physical activity is perceived as threatening   October 26th, 2017
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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Risk factor for the development of pain in breast cancer survivors   September 11th, 2017
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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‘Wouldn’t it be better to build up a child with chronic pain than it is to repair an adult?’   September 10th, 2017
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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My pain or our pain? The importance of parental factors in pediatric (chronic) pain   August 24th, 2017
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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Automated classification of chronic pain conditions using brain imaging: science fiction or reality of the future?   August 23rd, 2017
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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Pain Neuroscience Education: are we ready for the psychologist?   August 16th, 2017
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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Diagnosing pain mechanisms in low back pain: mission possible?   July 14th, 2017
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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Two PiM members recently obtained their PhD   June 6th, 2017
​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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The greatest common divisor of post-cancer, pediatric and sport-related pain: modern pain neuroscience   May 2nd, 2017
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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A daily dose of pain? A physical therapist deals with it…   May 1st, 2017
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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What you see, is what you get … but you ain’t seen nothing yet!   March 27th, 2017
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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​Sensorimotor incongruence, a true contributor to chronic pain?   March 16th, 2017
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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Context effect in physiotherapy Is it time to potentiate our clinical practice by integration of placebo responses?   March 15th, 2017
Patient’s pain and disability improvement is an everyday challenge for physiotherapists.
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Joint Forces – working transdisciplinary   January 30th, 2017
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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Changing our own (therapeutic) behavior is more difficult than changing our patients’ behaviour   January 11th, 2017
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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Pain attention: an important interaction   January 9th, 2017
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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Are athletes special people?   November 28th, 2016
Of course they are. We all have witnessed them and their exceptional performances during last summers’ Olympic games, the once-every-four-year alibi for sports fanatics to avoid bodily movement while watching their favourites giving the best of themselves.
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WCPT Post-congress course: Osteoarthritis: Balancing Biomechanics with Pain Neuroscience   November 27th, 2016
On the 5th of July, Dr Isabel Baert, Dr Enrique Lluch en Dr Mira Meeus, all Pain in Motion members, will give a post-congress course at the World Congress of Physiotherapy (WCPT), together with Dr Ina Diener, from Stellenbosch University and University of the Western Cape.
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Pain neuroscience education for patients undergoing lumbar surgery?   November 26th, 2016
On October 3rd 2016 a (Dutch) blog post was published on our website concerning a study comparing ‘back school’ and ‘brain school’ in patients undergoing surgery for lumbar radiculopathy, titled “Rugschool of pijneducatie bij chirurgie voor lage rug- en beenpijn”.
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Pain Treatment in Temporomandibular Disorders and Orofacial Pain: LESS IS MORE   November 25th, 2016
Temporomandibular Disorders (TMD) and orofacial pain are conditions that have been drawing more attention from Physical Therapists (PTs) in the recent years.
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What you see is what you get?   November 24th, 2016
What you see is what you get, no? Not for whiplash patients!
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7 geboden voor mensen met lage rugpijn   October 12th, 2016
Lage rugpijn blijft één van de duurste en meest invaliderende problemen van onze Westerse samenleving. Logisch dus dat voor vele stakeholders (patiënten, paramedici, artsen, firma’s en overheden) de focus hierop ligt.
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What pain education programs can learn from teachers and their class with 6-year olds…   October 11th, 2016
In Belgium nearly every hospital has a specialized pain center to treat patients with chronic and/or debilitating pain. These pain centers developed and evolved over the years and became multidisciplinary teams.
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Netwerk Pijnrevalidatie Limburg (Nederland)   October 9th, 2016
Het Expertisecentrum Pijn en Revalidatie, waarin Adelante en MUMC+ samenwerken op het gebied van chronische pijn, streeft naar toegankelijke revalidatiezorg bij chronische pijn voor zeer complexe en minder complexe problematiek. Hiervoor lanceert zij het Netwerk Pijnrevalidatie Limburg.
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Margot De Kooning, PhD candidate   October 4th, 2016
(August 30, 2016) 7:15 pm: The moment Margot De Kooning got rewarded for five years of hard work, by being promoted to ‘Doctor in Rehabilitation Sciences and Physiotherapy’.
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​Rugschool of pijneducatie bij chirurgie voor lage rug-en beenpijn?   October 3rd, 2016
Jaarlijks worden enkele duizenden patiënten geopereerd voor lage rugpijn met uitstraling naar het been (lumbale radiculopathie). Onderzoek wijst uit dat 23-28% postoperatief chronische pijn zullen ontwikkelen.
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Pneumogastric (Vagus) Nerve Activity Indexed by Heart Rate Variability in Chronic Pain Patients Compared to Healthy Controls: A Systematic Review and Meta-Analysis   October 1st, 2016
In this blogpost, the most important elements of this systematic review and meta-analysis are highlighted.
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Measuring activity limitations and participation restrictions in patients with chronic fatigue syndrome   August 31st, 2016
Chronic fatigue syndrome (CFS) is a complex syndrome with severe and debilitating fatigue. The experienced fatigue is not sufficiently reduced by resting, causing patients to perform less occupational, educational, social or personal activities and consequently restricting their participation.
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Chronic Whiplash-Associated Disorders: Reorganization of the Brain?   August 31st, 2016
A wide range of human brain imaging techniques has provided the opportunity to explore in vivo the neurophysiological processes of the brain. This neuroimaging research has shown neuronal plasticity, which refers to the possibility of the central nervous system including the brain to adapt but also to maladapt structure, function and organization.
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Psychosocial factors play an important role in the course of shoulder pain   August 31st, 2016
Shoulder complaints are common in physiotherapy practice and consist of pain and functional limitations.
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Whiplash, painful stress or stressful pain? Pain modulation in patients with whiplash associated disorders: studies examining the role of the autonomic nervous system and visual feedback   August 17th, 2016
Margot De Kooning will present her PhD in public on Tuesday 30 August 2016 at the Vrije Universiteit Brussel, Brussels Health Campus (Jette).
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Central sensitisation and sensory hypo-sensitivity: a paradox or a sub-grouping?   July 25th, 2016
The current definition of central sensitisation (CS) pain describes CS as manifesting in a generalised hyper-sensitivity of the somatosensory system.
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Dysfunction and treatment implications regarding the pectoralis minor in shoulder impingement syndrome   June 1st, 2016
The scapula plays an important role in the function of the shoulder. During humeral elevation of the arm, a complex scapular movement of upward rotation, posterior tilt and external rotation is needed to create a stable base for the glenohumeral joint.
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Five Requirements for Effective Pain Neuroscience Education in physiotherapy practice   June 1st, 2016
Pain neuroscience has taught us that pain can be present without tissue damage, is often disproportionate to tissue damage, and that tissue damage (and nociception) does not necessarily result in the feeling of pain.
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Moving on to movement in patients with chronic joint pain   May 9th, 2016
In the new edition of ‘Pain: Clinical Updates’ we published in connection with the ‘2016 IASP Global Year Against Pain in the Joints’ an overview paper to help clinicians prescribing/developing exercise programs for patients with chronic joint pain.
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The patient with pain is central not the therapist   May 9th, 2016
​One important aspect of dealing with patients with central pain syndromes is that no two patients are the same. Patients with persistent pain differ in their complaints and pain characteristics. Besides their pain related symptomatology, also their coping-style is different.
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Reappraising entrapment neuropathies: Mechanisms, diagnosis and management   May 9th, 2016
Traditionally the clinical manifestation of entrapment neuropathies (e.g., carpal tunnel syndrome, cervical and lumbar radiculopathy) is considered to be driven by local mechanisms and signs and symptoms should follow a clear anatomical pattern limited to the structures innervated by the affected peripheral nerve, or restricted to the corresponding dermatome, myotome and sclerotome.
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Effect of joint mobilization on central pain processing in knee osteoarthritis   May 9th, 2016
Knee osteoarthritis (OA) is predominately characterized by knee pain, which can lead to impaired physical function and decreased quality of life
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Chronic stress affects brain morphology and functioning: relevance to cancer survivors and chronic pain?   April 4th, 2016
Many patients with chronic pain suffer from stress intolerance, and some patients have developed chronic pain during or following a stressful period or (life) event (e.g. motor vehicle accident, trauma exposure). When chronic pain is present, stress typically worsens the pain (severity). Taken together, stress and chronic pain are closely connected. In this blog post fascinating research findings regarding the effect of chronic stress on the brain are presented, providing a neuroscientific explanation why chronic stress may lead to the development of chronic pain.
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The nocebo effects of communication   March 21st, 2016
I once was told by a former colleague that I would most definitely get back pain if I didn’t stop slumping in my L1 vertebra. Of course today I am still ‘slumping in my L1 vertebra’ and no, I don’t believe that it will ever cause me back pain.
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Neck pain, cervical movement control dysfunction and the influence of scapula on neck pain: results of a PhD   March 19th, 2016
Recently, I finished my PhD on Fisioterapia Manual at the University of Alcalá (Madrid, Spain). This PhD comprises five manuscripts related to neck pain, cervical movement control dysfunction and the influence of scapula on neck pain.
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The periaqueductal gray (PAG): not just a simple node in descending pain modulation   March 19th, 2016
The role of the periaqueductal gray (PAG) has been described in many studies regarding pain processing. This structure, located in the midbrain around the cerebral aqueduct, is mainly known as a key region in descending pain modulation.
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Chronic pain in athletes: Is it time to change our point of view?   March 19th, 2016
The prevalence of chronic sports injuries is high, while the etiology and pathophysiological mechanisms have largely remained unknown. To date, the most commonly used approach is limited to a biomedical one, focused on abnormalities and inflammation.
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EIPQ-R or brief IPQ: Can we safely use it in patients with musculoskeletal disorders?   January 1st, 2015
​In November 2015 a short summary of our review in Manual Therapy (Leysen et al. 2015) will be published in FysioPraxis (Fysiopraxis Nov. 2015, p39), the monthly magazine of physiotherapy in the Netherlands.
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Can pain neurophysiology education improve exercise effects in chronic low back pain patients?   January 1st, 2015
Research has suggested that exercise is effective in the treatment of chronic low back pain (CLBP), regardless the characteristics of the exercise selected. Although it’s effective, exercise as intervention alone does not seem to take into consideration the maladaptive pain cognitions and illness behavioural characteristics frequently identified in CLBP patients.
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The inclusion of personality type highlights differences in the experience of pain and response to pain management   January 1st, 2015
​Chronic musculoskeletal pain is a complex problem and has significant psychological, physical, social and economic implications. There is inevitable pressure for hospitals to reduce waiting times and improve treatment outcomes. Given the significant burden upon the individual, society and the economy, it is important to identify more effective management strategies.
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Brain-derived neurotrophic factor (BDNF) as a driving force behind central sensitization pain: a new therapeutic target?   January 1st, 2015
The awareness is growing that neurotrophic factors, like brain-derived neurotrophic factor (BDNF), have a cardinal role in initiating and/or sustaining the hyperexcitability of central neurons in chronic pain patients. For example, microglial-derived BDNF contributes significantly to neuropathic pain. Therefore, potential pharmacological or conservative (e.g. exercise) treatment of neurotrophic factors like BDNF provides important new treatment avenues.
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Findings from a recent systematic review and meta-analysis: evidence suggests pain sensitization in people with knee osteoarthritis   January 1st, 2015
​Osteoarthritis (OA) is traditionally considered a progressive disorder of articular cartilage in the joint, yet increasing evidence suggests that at least in an important subgroup of patients with OA the clinical picture is dominated by sensitization of central nervous system pain pathways (i.e. central sensitization) rather than by structural dysfunctions causing nociceptive pain (reviewed by Lluch et al. 2013).
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Neurophysiological aspects of trait anxiety and possible links with sensory processing alterations and central sensitisation   January 1st, 2015
Trait anxiety is an enduring (i.e. relatively stable) personality trait, or characteristic, indicative of differences in an individual's proneness to reactions of state anxiety when faced with a perceived psychological threat. (Compare this with state anxiety which is transient, in the present.)
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Case Study: Central Sensitisation, Sensory Processing and Trait Anxiety profiles in two Chronic Low Back Pain patients   January 1st, 2015
Clinically it is important to distinguish between the three main pain mechanisms that may present with our patients experiencing chronic pain (Nijs et al 2014). Here I describe my clinical findings in two chronic low back pain patients, one with chronic nociceptive pain and the other with chronic central pain mechanisms.
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Experts van vijf universiteiten en behandelcentra pleiten samen voor multidisciplinair onderzoek ter verbetering van de zorg voor CVS-patiënten   January 1st, 2015
Het chronische vermoeidheidssyndroom (CVS) is een erg onderschatte en nog te weinig bestudeerde aandoening. Naar schatting treft CVS 0.5 tot 2.5% van de bevolking. De aandoening gaat gepaard met een zeer hoge medische, economische en sociale kost. Experts van vijf Belgische universiteiten trekken met een open brief aan de alarmbel.
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Myofascial trigger points: fact or myth? Let the battle continue   January 1st, 2015
The concept of myofascial trigger points keeps on inspiring researchers and clinicians. With the recent publication of an interesting review article in Rheumatology, the concept is really challenged.
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Potentiating placebo-analgesia in clinical practice   January 1st, 2015
Manchikanti and colleagues (2011) make in their paper entitled ‘placebo and nocebo in interventional pain management: a friend or a foe – or simply foes?’ an argument for a revaluation of placebo effects in clinical practice. They make the claim that clinicians should not try to avoid the placebo effect, but should try to potentiate it, as this effect isn’t just unethical and mythical but must seen as a very real phenomenon, which can be understood from a vast body of both psychological and neurophysiological research.
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Can we retrain the brain? Yes we can! Evidence from pediatric complex regional pain syndrome   January 1st, 2015
A new fascinating study from the Harvard Medical School (Boston, U.S.A.) adds to the evidence that conservative interventions can retrain the brain (ref. 1). Laura Simons and her colleagues reported marked differences in functional brain connectivity between pediatric complex regional pain syndrome patients and age-sex matched control subjects, but also normalization of such differences following in-house rehabilitation.
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Pain affects cognition: the role of gabapentin and noradrenergic signaling in the brain   January 1st, 2015
There is strong evidence that patients with chronic pain show decreased cognitive task performance, including decreased sustained selective attention, processing speed and memory. Pain in Motion recently reported on Kelly Ickmans’ PhD findings, showing that in patients with various central sensitization pain disorders (fibromyalgia, chronic whiplash associated disorders, chronic fatigue syndrome), cognitive performance is closely related to physical activity levels and endogenous analgesia.
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Anxiety and central sensitisation (CS) but without CS pain?   January 1st, 2015
​This is short case study with observations from the clinic which may raise interesting research questions.
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Which outcome domains should be measured in clinical trials conducted in patients with non-specific low back pain?   January 1st, 2015
​There is wide international consensus on the need of having agreed and standardised sets of outcomes, better known as ‘core outcome sets’ (COSs). A COS represents the minimum that should be measured and reported in all clinical trials for a specific health condition, and that can also be suitable for use in other types of studies or clinical practice.
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Innovative Brain Imaging Study: Smoking increases Risk of Pain Chronification in Back Pain Patients   January 1st, 2015
Chronic back pain (CBP) is an important clinical, social, economic, and public health problem. Many risk factors are associated with CBP. However, the evidence is often cross-sectional. In an innovative study, researchers from the Northwestern University of Chicago explored the relationship between smoking, transition to chronic pain and functional characteristics of the brain.
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Central sensitization pain : Where are we now and which options do we have for treatment?   January 1st, 2015
Conventional rehabilitation for people with chronic pain is often unsuccessful and frustrating for clinicians. What it is becoming clear more and more is that new therapeutic approaches are needed in view of current understanding of neural mechanisms underpinning chronic pain. In this regard, three papers aiming to summarize the role of central sensitization in chronic musculoskeletal pain and looking for guide clinicians in the rehabilitation of patients with chronic pain have been recently published.
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Low back pain: Criteria for differentiating between nociceptive, neurophatic and central sensitization pain in clinical practice   January 1st, 2015
​Pain is the number one reason for patients visiting a physiotherapist. Chronic pain is the most costly condition affecting the Western world. This comes as no surprise: pain is omniprevalent among a wide variety of medical disciplines, ranging from oncology, pediatrics, geriatrics, rheumatology, orthopedics, neurology and internal medicine. For reducing the costs associated with chronic pain, correct mechanism-based classification of the pain type is the first step.
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Artrose: thinking beyond muscles & joints Online lezing van het E-Wise symposium in Domus Medica te Utrecht (8 november 2014)   January 1st, 2015

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Exercise therapy reduces aromatase inhibitor-induced arthralgia in breast cancer survivors   January 1st, 2015
​Postmenopausal women with hormone receptor-positive breast cancer receive hormone therapy as part of their cancer treatment. One of the most frequently used and evidence-based hormone treatments are aromatase inhibitors (= inhibitors of the enzyme aromatase) that inhibit the conversion of androgens to estrogens. This results in decreased availability of estrogens and slowed progression of breast cancer.
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Neutral images can reinstate pain-related brain activation: Experimental evidence for a memory-based mechanism of pain amplification   January 1st, 2015
​Remembering an event reactivates at least part of the cortical and subcortical regions that were engaged during the original experience of that event. This is termed “reinstatement” of brain activity during memory retrieval. German and UK researchers have conducted a fascinating study showing reinstatement of pain-related brain activation during viewing of neural images that had previously been paired with heat pain.
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Scapular assessment and its place within clinical reasoning   January 1st, 2015
​Scapular dyskinesia has been widely accepted in the literature as associated with glenohumeral joint pathology. Clinicians who manage patients with shoulder pain need to have the skills to assess static and dynamic scapular positioning. At this point, clinicians can use reliable (and valid) clinical tests for the assessment of both static and dynamic scapular positioning in patients with shoulder pain.
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Wandering about the effects of visual feedback on pain   January 1st, 2015
​Some months ago I came across a novel study by Harvie and colleagues (2015); they used virtual reality to investigate the effect of overstated or understated visual information on cervical rotation in patients with neck pain. This empirical study shows that we might need to reconsider how we interpret diagnostic provocation tests in daily care, e.g. that it is not a solid measurement for primary nociceptive information or tissue provocation.
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Why does my knee still hurt after knee arthroplasty? Because they only treated your knee, not your central nervous system!   January 1st, 2015
​Osteoarthritis (OA) of the knee has long time been considered as a structural pathology with a clear nociceptive explanation, resulting from joint degeneration. Nevertheless, recently awareness is growing for the involvement of the central nervous system in the amplification of pain in OA. This may explain why many patients still suffer chronic pain after surgery, long time after removal of the source of nociception.
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Where is the pain? The teachings of philosophy and neuroscience   January 1st, 2015
​During the last decade there has been much discussion about pain and its manifestations, their presence and, naturally, their absence. As physiotherapists and health care professionals we have taken tools from other disciplines to advance in our own; we adopted neuroscience (for understanding the functioning of our nervous system) and philosophy (for understanding how the mind works). In theory everything is clear to us, but in reality our knowledge does not always correlate with clinical outcomes.
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Hoe denkt u over pijn?   January 1st, 2015
​In juli 2015 heeft retrain pain een educatieve tool gelanceerd die u als professional kan ondersteunen bij het geven van pijneducatie aan uw patiënten.Sindsdien zijn wij bezig geweest met de Nederlandse vertaling. Wij zijn enthousiast om te kunnen melden dat deze af is!​
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Altered central pain modulation pre-surgical might influence outcome after total knee replacement: a systematic review   January 1st, 2015
​Even though a total knee replacement is an effective surgical treatment for end-stage knee osteoarthritis and the majority of patients report significant pain relief and functional improvement post-surgical, literature shows that up to 20% of patients undergoing a total knee replacement are dissatisfied and complain of persisting pain, functional disability and poor QoL ( Scott et al. 2010).
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History taking during the first consultation of patients with low back pain: What do physiotherapists ask?   January 1st, 2015
​Several studies demonstrated the importance of assessing the perceptions of patients regarding their illness (i.e. the illness perceptions) as they are of prognostic value.
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The balancing exercise of exercise prescription in chronic pain?   January 1st, 2015
​In a very recent review and clinical guideline of Heather Kroll, a nice overview is given about how exercise affects pain. But besides listing possible mechanisms of exercise induced analgesia, she reviews the therapeutic modalities and benefits for a wide variety of chronic pain diagnoses.
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Activity pacing self-management program helps in optimizing participation in desired life activities in women with CFS   January 1st, 2015
​People with chronic fatigue syndrome (CFS) may be limited in activity performance and role fulfilment to a large extent. A lot of them enter a vicious circle of inactivity, leading to increased levels of fatigue. It is therefore important to break this negative process. One of the approaches is to facilitate people with CFS in self-managing their daily activity levels.
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Exercise therapy for rewriting pain memories? Applying graded exposure in vivo principles during exercise therapy for targeting the brain circuitries orchestrated by the amygdala   January 1st, 2014
Even though nociceptive pathology has often long subsided, the brain of patients with chronic musculoskeletal pain has typically acquired a protective (movement-related) pain memory. Exercise therapy for patients with chronic musculoskeletal pain is often hampered by such pain memories.
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Pain neuroscience education for treating Cyberchondria. Is Google really your friend?   January 1st, 2014
The internet is nowadays a popular information source for the general public when it comes to medical advice. It is an easy to use and very cheap source of information, which may lead to less medical consults. On the other hand, it can have several negative effects, like an overload of information, increased anxiety, distress, and compulsive search for medical information. Recently, this phenomenon has been referred to as “Cyberchondria”.
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Does central sensitization play a role in chronic tendinopathy?   January 1st, 2014
The prevalence of tendinopathies is high both in athletes and in the general population. Despite a wealth of literature, the pain mechanisms of tendinopathies are not well understood. Currently, some studies have described whether, or to which degree, somatosensory changes within the nervous system may contribute to the pain in tendinopathies.
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Why does my shoulder hurt?   January 1st, 2014
Dean et al. recently reviewed the neuroanatomical and biochemical basis of shoulder pain. Shoulder pain is often a very challenging clinical phenomenon because of the potential mismatch between pathology and the perception of pain. As shoulder pain is very common in the physiotherapeutic clinical practice, a vast understanding of pain processing could enlarge the specificity of the patients’ diagnosis and steer treatment.
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In the subacromial space or in the brain? Central nervous system sensitization in patients with shoulder pain   January 1st, 2014
Hyperexcitability of the central nervous system, or central sensitization, is considered to be a maladaptive type of neuroplasticity often seen in patients with chronic pain. Central sensitization is frequently seen in patients with osteoarthritis, fibromyalgia, whiplash, neuropathic pain and chronic fatigue syndrome. Up to recently, shoulder pain was considered to be a pure ‘local’ problem. Tissues that are frequently linked to shoulder pain include (rotator cuff) muscles, ligaments, subacromial bursa and joint capsules.
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WILL COMPUTERS REPLACE THERAPISTS? THERAPEUTIC PAIN NEUROSCIENCE EDUCATION VIA E-MAIL   January 1st, 2014
Therapeutic pain neuroscience education (TPNE) is becoming increasingly popular as (part of) the treatment of (chronic) pain and aims at altering the patient’s thoughts and beliefs about pain. Previous research has demonstrated the efficacy of TPNE in the treatment of chronic pain. TPNE is mostly given in one-on-one sessions, which has limitations, as it is time intensive, cost intensive and limited to patients in remote areas. Pain in Motion previously showed that written TPNE does little to alter pain, pain cognitions or illness perceptions in patients with fibromyalgia.
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Tea with discussions about combining manual therapy with pain neuroscience education   January 1st, 2014
Interpreting scientific results in clinical practice can be, to say at least, challenging. Especially when it is somewhat contradictory to what you have heard during all those years of extensive training in both physiotherapy education and other courses. As one of my friends recently put it this way: ‘The more I learn about pain, the less I know and the more confused I get.’
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Fysiopraxis Themanummer Pijn   January 1st, 2014
Het vaktijdschrift voor fysiotherapeuten in Nederland, Fysiopraxis, heeft in een themanummer over pijn aandacht besteed aan pijn in alle vormen. Hierbij zijn vele experts op het gebied van (chronische) pijn benaderd. Vanuit de onderzoeksgroep Pain in Motion zijn er meerdere onderzoekers betrokken geweest bij dit themanummer. Zo is Jo Nijs aan het woord over waarom juist pijn een indicatie is om te behandelen.
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Cognitive performance in patients with chronic central sensitization pain   January 1st, 2014
Persistent pain in the absence of structural pathology remains a challenging issue for clinicians. Besides the suffering from the pain itself, chronic ‘unexplained’ pain is often accompanied by other debilitating symptoms such as fatigue, sleep difficulties, dizziness, psychological symptoms, and cognitive problems among others. A growing body of scientific research underlines the involvement of a common pathophysiological mechanism of central sensitization (CS), commonly known as an hypersensitivity of the central nervous system, in overlapping chronic pain conditions such as chronic fatigue syndrome (CFS), fibromyalgia (FM) and chronic whiplash-associated disorders (WAD).
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Not in the mind, but in the immune system! Altered immune response to exercise in patients with chronic fatigue syndrome/myalgic encephalomyelitis   January 1st, 2014
Chronic Fatigue Syndrome (CFS), or myalgic encephalomyeltitis (ME), is a severe and underestimated illness. The presence of symptoms like a sore throat, tender lymph nodes, and low-grade fever, as well as flu-like symptoms including widespread muscle pain and severe fatigue, has inspired researchers to search for immune abnormalities in patients with ME/CFS.
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Pain increases during walking in osteoarthritis related to central sensitization   January 1st, 2014
The April issue of Pain reports a sound study examining self-perceived pain changes during walking in patients with osteoarthritis. Pain in Motion previously reported that up to 30% of osteoarthritis patients have central sensitization, and this new study from U.S. researchers suggests a role for central sensitization in explaining pain changes during daily physical activities like walking
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Treatment Options for Central Sensitization Pain in Clinical Practice   January 1st, 2014
In 2011, Pain in Motion published a paper explaining to clinicians the various options we have for treating the mechanisms involved in central sensitization.
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Combining pain neuroscience education with hands-on manual therapy in patients with osteoarthritis and central sensitization pain   January 1st, 2014
A systematic literature review recently showed that approximately 30% of patients with osteoarthritis have central sensitization pain, implying that their pain is dominated by central factors (i.e. the increased hyperexcitability of the central nervous system) rather than peripheral (i.e. joint) factors.
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Effect of relaxation in patients with Fibromyalgia: a literature study   January 1st, 2014
Based on a literature study on the effects of relaxation on symptoms and daily functioning in patients with FM, the authors concluded that:
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Severe STRESS reduces the BRAIN’s capacity to control PAIN   January 1st, 2014
Stress is often a powerful pain killer. Stress activates several brain-orchestrated pain inhibitory actions, including the activation of the hypothalamus-pituitary-adrenal axis (HPA-axis) resulting in the release of cortisol. The latter is often regarded as the major stress hormone in the human body, and besides its powerful anti-inflammatory action it also exerts endogenous analgesia.
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Low back pain: Simultaneous top-down + bottom-up approach for treating central sensitization?   January 1st, 2014
The study by Schabrun et al. published in Brain Stimulation 2014 is one of the most interesting papers I have read last year. This might be due to the fact that I am not at all an expert in neuromodulation, but even so the study is highly innovative and has amazing findings. The paper reports a placebo-controlled cross-over study investigating the effect of transcranial direct current stimulation (tDCS) combined with peripheral electrical stimulation (PES) treatment on pain, cortical organization, sensitization and sensory function in 16 patients with chronic low back pain. It was found that a combined tDCS/PES intervention is more effective for improving not only chronic low back pain symptoms, but also for improving the mechanisms of cortical organization and central sensitization than either intervention applied alone or a sham control.
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The Psychological Flexibility Model: A basis for integration and Progress in Psychological Approaches to Chronic Pain Management   January 1st, 2014
A recent article by Lance M. Mc Cracken and Stephen Morley published in the Journal of Pain addresses the place of theory and models in psychological research and treatment development in chronic pain. It argued that such models are not merely an academic issue but are highly practical. Such models ought to integrate current findings, precisely guide research and treatment development, and create progress. The dominant psychological approach to chronic pain is cognitive behavioural therapy (CBT).
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