Adiemusfree

233 posts · 198,867 views

Bronwyn Thompson is a pain management clinician and senior clinical lecturer in pain management. She writes from a biopsychosocial perspective, and primarily discusses psychosocial management of chronic pain.

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  • March 29, 2010
  • 02:35 PM
  • 3,219 views

“You’re just being a hypochondriac” – health anxiety & chronic pain

by Adiemusfree in Healthskills: Skills for Healthy Living


I think that label has to be one of the most feared amongst the people I see with chronic pain.  To be judged as being obsessed about nonexistant illnesses when actually having pain every day must be incredibly difficult to cope with.  At the same time, being anxious about health and having mistaken beliefs about [...]... Read more »

  • February 21, 2010
  • 01:33 PM
  • 1,978 views

People with high risk factors for disability get more biomedical information

by Adiemusfree in Healthskills: Skills for Healthy Living


For a couple of years now, the focus of researchers on factors that identify ‘high risk’ of ongoing disability has turned from patients and onto providers. I’ve written before that health provider’s own beliefs about pain, particularly pain-related anxiety and avoidance, can change the advice they give. This can lead to less ‘reassurance’ about [...]... Read more »

Shaw WS, Pransky G, Winters T, Tveito TH, Larson SM, & Roter DL. (2009) Does the presence of psychosocial "yellow flags" alter patient-provider communication for work-related, acute low back pain?. Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine, 51(9), 1032-40. PMID: 19687758  

  • November 17, 2008
  • 07:34 PM
  • 1,799 views

Adding graded exposure or graded activity makes no difference…

by Adiemusfree in Healthskills: Skills for Healthy Living

A phenomenon well-known in academic circles is called publication bias.  This is where negative or equivocal findings are not published in favour of studies where results are positive.  Today I’m going to counter this bias by discussing a study in which physiotherapy based on treatment classification with either graded exposure or graded activity was compared [...]... Read more »

  • September 20, 2010
  • 04:02 AM
  • 1,739 views

Sleep problems in chronic pain & what helps

by Adiemusfree in Healthskills: Skills for Healthy Living

I have written about sleep problems in people with chronic pain several times. It is one of those aspects of dealing with pain that inevitably arise as I talk with people about energy, their activity through the day, and their mood. Many people blame the pain for their sleep problems, which is unsurprising really – … Read more... Read more »

  • December 15, 2008
  • 02:59 AM
  • 1,676 views

Coping strategies survey - the results!

by Adiemusfree in Healthskills: Skills for Healthy Living

Over the next couple of days I’m going to review the coping strategies survey I’ve been running.  I’ve had 33 participants, so it’s not a large sample, but it does represent some of the professions working in the field of chronic pain.

Who responded?

12.5%   Social workers

4.2%     Nurse

29.2%  Occupational therapists

25%      Physiotherapists

12.5%  Medical [...]... Read more »

  • December 9, 2008
  • 02:17 AM
  • 1,642 views

When patients set the goals of therapy…

by Adiemusfree in Healthskills: Skills for Healthy Living

If you’ve been following my blog over the past week or so, you’ll see I’ve been discussion goal setting as part of pain management rehabilitation.  I’ve looked at the things patients may ask for, and the difference between these goals and the goals that clinicians may need to set directly related to the treatment aims. [...]... Read more »

  • December 8, 2008
  • 12:13 AM
  • 1,616 views

Pain intensity does not correlate with life satisfaction in people with long-term pain

by Adiemusfree in Healthskills: Skills for Healthy Living

A hotly debated question in some pain management clinicians minds is whether to simply address pain intensity, or to focus on ‘other’ issues such as improved function, reduced distress, reduced fear, better mood and so on.  Well, to me it’s no debate, actually.  I can’t provide pain reduction strategies per se - I’m not a [...]... Read more »

  • March 4, 2009
  • 06:31 PM
  • 1,612 views

Graded exercise or walks for recurrent low back pain

by Adiemusfree in Healthskills: Skills for Healthy Living

As a confirmed exercise-free zone, I am always interested in studies that look at whether specific exercise makes a difference in recovery for people with chronic pain.  My preference is to dance (yes, belly dance is good!), and I enjoy walking and cycling, but gyms? no way!

This study caught my eye because it is a [...]... Read more »

  • January 20, 2009
  • 02:25 AM
  • 1,602 views

What’s getting in the way of good pain management in rheumatoid arthritis?

by Adiemusfree in Healthskills: Skills for Healthy Living

It seems obvious, doesn’t it, that if there is a good understanding of the mechanism of a painful disease, some effective ways to treat it, and it’s an ‘acceptable’ disease to have (unlike some mental health disorders) - then people with the disease should really have great pain relief…or is it?

This study by Fitzcharles, DaCosta, [...]... Read more »

  • March 31, 2009
  • 02:33 PM
  • 1,602 views

Feeling the fear - and not even thinking about doing it

by Adiemusfree in Healthskills: Skills for Healthy Living

Anxiety sensitivity (AS) is basically the fear of feeling anxious, or feeling anxiety-related symptoms. Typically, when people are fearful of their own symptoms of anxiety, they’ll work to avoid getting into situations where they may experience these symptoms.  AS has been shown to be a predisposing factor in some anxiety-related disorders such as panic attacks.   [...]... Read more »

  • December 11, 2008
  • 01:54 PM
  • 1,582 views

Goal-setting: the professionals’ perspective

by Adiemusfree in Healthskills: Skills for Healthy Living

In a qualitative study, Diane Playford and colleagues explore the views of health professionals who use goals and goal-setting within a rehabilitation context.  This study was carried out with a group of health professionals working in rehabilitation in a variety of contexts - elder care, inpatient and community-based teams, as well as health care educators [...]... Read more »

  • November 24, 2008
  • 01:37 AM
  • 1,580 views

Pacing: What’s the evidence for it?

by Adiemusfree in Healthskills: Skills for Healthy Living

Pacing is one of those words: almost every person who has been through a pain management programme of any sort will roll their eyes and groan ‘pacing’ when asked about one of their least favourite strategies.

I have long disliked the word because of the mixed ways in which therapists (and patients) interpret what it actually [...]... Read more »

  • April 15, 2009
  • 06:13 PM
  • 1,571 views

Therapy: Art or Science?

by Adiemusfree in Healthskills: Skills for Healthy Living

Is pain management an art or a science? Or both?

I am proud to call myself a clinical scientist, or scientist practitioner. This probably stems from when I started University study and enrolled in a Science degree rather than an Arts degree - even though the papers and courses were identical!

I went onto Google to search [...]... Read more »

Panda S.C. (2006) Medicine: Science Or Art?. Mens Sana Monographs, III:6(IV:1-4), 127-138.

  • January 19, 2009
  • 01:01 PM
  • 1,561 views

Quality assessment of diagnostic accuracy

by Adiemusfree in Healthskills: Skills for Healthy Living

I was taking a moment or two to looked through some of my RSS feeds, and came across this post on the quality of diagnostic accuracy.  QUADAS stands for:

Q – Quality

A – Assessment of

D – Diagnostic

A – Accuracy

S – Studies

It’s especially developed for people who use physical assessment, and in this post written by physiotherapist [...]... Read more »

  • January 15, 2009
  • 03:05 PM
  • 1,545 views

Pain Catastrophizing and Pain-Related Fear in Osteoarthritis Patients: Relationships to Pain and Disability

by Adiemusfree in Healthskills: Skills for Healthy Living

There was a time when unless tissue damage could be seen on X-ray or scan, pain was thought to be either imaginery or ‘psychogenic’. As time has gone on, it’s more common than not to read that people have chronic pain (such as neuropathic pain) that is present without evidence on some sort of [...]... Read more »

T SOMERS, F KEEFE, J PELLS, K DIXON, S WATERS, P RIORDAN, J BLUMENTHAL, D MCKEE, L LACAILLE, & J TUCKER. (2008) Pain Catastrophizing and Pain-Related Fear in Osteoarthritis Patients: Relationships to Pain and Disability. Journal of Pain and Symptom Management. DOI: 10.1016/j.jpainsymman.2008.05.009  

  • February 23, 2009
  • 02:36 AM
  • 1,538 views

Drifting… from the plan: evidence-based treatment and therapist drift

by Adiemusfree in Healthskills: Skills for Healthy Living

It’s not something we like to talk about.  In fact, it’s something I think many of us don’t really even know about.  What I’m talking of is how therapists drift, stray, or deviate from what is evidence-based treatment into what is not.

Strangely enough, I’ve been thinking of this in relation to my post yesterday about [...]... Read more »

Glenn Waller. (2009) Evidence-based treatment and therapist drift. Behaviour Research and Therapy, 47(2), 119-127. DOI: 10.1016/j.brat.2008.10.018  

  • January 19, 2009
  • 12:29 AM
  • 1,508 views

PHODA findings - chronic low back pain and people with high and low kinesiophobia

by Adiemusfree in Healthskills: Skills for Healthy Living

I’ve written quite a few times about the PHODA - photographs of activities of daily living - and I’m in the process of developing a New Zealand contextual version of it for use in the Pain Management Centre in which I work.  Today I’m briefly discussing another paper in press about the use of a [...]... Read more »

  • June 24, 2009
  • 03:11 PM
  • 1,497 views

Splish! Splash! Hydrotherapy for chronic back pain is pretty good!

by Adiemusfree in Healthskills: Skills for Healthy Living

Just a quickie post this morning, but one that I couldn’t resist.

You know how nice it is to be soaking in a hot bath or hot pools after doing some great energetic thing (vacuuming the house? gardening?) – and how many people with chronic pain tell us that a soak in a bath or a [...]... Read more »

Dundar U, Solak O, Yigit I, Evcik D, Kavuncu V. (2009) Clinical effectiveness of aquatic exercise to treat chronic low back pain: a randomized controlled trial. Spine, 34(14), 1436-1440.

  • May 18, 2009
  • 03:25 PM
  • 1,462 views

Goal intentions or implementation intentions: which one works?

by Adiemusfree in Healthskills: Skills for Healthy Living

I thought it worth spending a little time considering goals because so many of us work to help people generate goals – but how many are completed? I’m sure I could lay money on the table that most of us have failed to persist with a goal when we’ve set one, and it’s no [...]... Read more »

  • December 2, 2008
  • 02:27 AM
  • 1,439 views

Meeting needs and making meaning: The pursuit of goals

by Adiemusfree in Healthskills: Skills for Healthy Living

Goals: setting them, working towards them, achieving them - they’re part of being human or so Brian Griffith and Catherine Graham say. In this article, they explore the Adlerian interpretation of goals as embodying the meaning of human life saying ‘goals reflect core values, reinforce an image of the ideal self, compensate for inferiority [...]... Read more »

Brian Griffith, & Catherine Graham. (2004) Meeting needs and making meaning: the pursuit of goals. Journal of Individual Psychology, 60(1), 25-41.

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