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Pain Ed
เข้าร่วมเมื่อ 9 เม.ย. 2013
Interview with Dr. Alexander Fraser
Dr. Alexander Fraser is Consultant Rheumatologist at University Hospital Limerick, Ireland. Here he discusses the impact of pain among his patients in many different ways - affecting not just physical function, but also sleep as well as mental and emotional health. He also discusses the personal nature of pain, which is not always obvious to others, and the role pain medications may (or may not) offer in managing chronic pain.
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Enhancing patient outcomes
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In this video, Dr. Larry Benz discusses the ways in which a range of evidence-based therapies can be further enhanced by incorporating some simple contextual or "non-specific" techniques.
Mary's story
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Mary had pain for several years, and it gradually became more widespread. Her pain became more severe over time and she experienced a lot of fatigue. She was diagnosed with fibromyalgia. Her pain was aggravated by many factors including stress and poor sleep. She struggled to maintain her usual social life. Using a multidimensional approach including education about what was happening to her bo...
Peter O'Sullivan: Pelvic pain: What are the really important factors to address in management?
มุมมอง 22K11 ปีที่แล้ว
In a small proportion of people who develop pelvic pain, it can become a very disabling, painful condition. For many years unhelpful beliefs about what happens to the pelvis among people with pelvic pain have been promoted. It is now increasingly clear that chronic pelvic pain, similar to other chronic pains such as chronic low back pain, usually involves a wide range of factors. The good news ...
Martin's interview with Prof Peter O'Sullivan: "I felt broken, i felt weak"
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Martin developed severe low back pain after an injury playing sport. Over the next 4 months his pain became more severe, limiting his ability to function across all aspects of his life. He attempted various interventions including core stability exercises but these did not help his pain. The pain had a major impact on his self-confidence and mental health. This video looks at Martin both when h...
Can this approach work in typical clinical practice - speaking to clinicians
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Can this approach work in typical clinical practice - speaking to clinicians
Can this approach work in typical clinical practice - the data
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Can this approach work in typical clinical practice - the data
Siobhan's story: "my vertebra was permanently crushed"
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Siobhan's story: "my vertebra was permanently crushed"
Michael's story: "all along you are told to protect yourself"
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Michael experienced severe back, buttock and leg pain for several years. It greatly affected his ability to participate in his normal sporting and social life. MRI scans showed disc bulges which he was told would limit how much physical activity he would ever be able to do. He discusses here the impact of the pain on his overall quality of life. He describes how he has regained a very good leve...
Anita's story: "The scans showed nothing..... there was no hope"
มุมมอง 81011 ปีที่แล้ว
Anita experienced severe back pain after a fall. Over the next seven years, the pain increased and affected her quality of life in several ways. She received lots of treatment, but if anything her disability increased over time. She discusses here the impact of chronic pain on her life, and how she has regained a very good level of function with much less pain. She highlights the importance of ...
Michael's story: "an enormous effect physically, and even more so mentally"
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Michael experienced severe back and leg pain while lifting one day. Over the next year, the pain returned whenever he tried to resume normal physical activities. It affected his ability to work, play golf and enjoy life in general. He was told he had damaged discs, nerves and that his spine was twisted. He discusses here the impact of chronic pain on his life, and how he has regained a very goo...
worst rheumatologist on the planet, avoid at all costs
how dare you talk about patients in excruciating pain, you left me with NO ANTI INFLAMMATORIES FOR 4 MONTHS
Great🖕
I FULLY relate to this man and it's comforting to me that he's obviously a successful, intelligent guy. I used to think I was stupid or weak for suffering this way, but this guy went through it and he's clearly not stupid or weak and HE thought that way too. It's literally a set of symptoms that can affect anyone given the right (or wrong, really) triggers and negative mind set and lack of relevant knowledge about back pain.
Does it feel like. You're vertabrae is pushed in..? Because on my 7 cervical vertabrae area...I feel like one is Pushed In .and two are popped out..idk if it's normal.. gap like i guess...tell.me is it? Or do i have something more serious???
Fantastic news Peter O'Sullivan. It is long time for a huge over hall in the education of our Health care professionals on the subject of Chronic pain.
can I ask, what about women who have hypermobility syndrome and therefore are prone to joint issues. I was treated on the NHS by a women's specialist, who realigned my pelvis, and gave a brace to prevent dislocation. Having had physio since a teenager I know the importance of keeping joint movement "normal" even when in pain. I do have a high pain threshold, I am allergic to most painkillers, have broken bones and dislocated joints on numerous occasions. PGP meant that I was physically unable to move my leg (pain wasn't the issue, try as much as I wanted the joint would not move without help). It is unlikely there would be charities who deal with PGP and help organise best practice if it was just women being stupid. I didn't even know what PGP was until I was diagnosed, so fear of it was not the issue.
Thanks Peter for this video. Firstly David, in my opinion you should show this man a little more respect. He is at the top of his field and has researched this area to great length; to say that what he is saying is nonsense is unfair and inaccurate. I am interested to understand your background in relation to this conversation? Personally I am a big fan of evidence in the form of peer reviewed research, both qualitative and quantitative. Peter has outlined evidence of this nature. To address Dr mum, your evidence may have some validity, however its almost 20 years out of date. Times change and research develops. Thanks again Peter. Keep up the good work.
To be clear - there is NO evidence that painful pelvic joints are associated with the bones of the pelvis being misaligned...or out of place...and movement of the joint is barely detectable in people with pain. There IS evidence that people with disabling pelvic pain present with lower pain thresholds to pressure and mechanical stress, have poorer sleep, are more fearful and develop protective muscle guarding over these painful joints...which may manifest as 'stiffness' - or asymmetry - no different to clenching your fist stiffening your wrist. There is also evidence that feeling like 'something is out of place' in your pelvis is common. This is likely to reflect a combination of altered body perception and altered patterns of muscle tension - but NOT altered positioning of the pelvic bones. The likely effect of manual therapies is to provide pain relief and reduce protective muscle guarding....but NOT to put the bones back into position as is often believed. See research by: Palsson et al Pain 2012, 152 (11) 2233-40 Palsson et al Clin J Pain, 2015, 31 (7) 542-51 Kibgsard et al Clin Biomech, 2014, 29,4 Beales et al Man ther, 2016,21 69-75 Palsson et al, J Pain, 2014, 16 (3)
This is nonsense. The SI joints, in particular, but any spinal or pelvic joint, can be misaligned or, in functional terms, have dysfunctional joint motion. All this can usually be corrected by mobilization or adjustment. Strengthening muscles around the joints helps preserve the adjustments. But to not tell people their joints are misaligned because they might be "afraid" (as you seem to suggest) is nuts! You are delaying people getting proper treatment. The "guarding" you are talking about is CNS mediated, involuntary, and NOT driven by conscious beliefs.
evidently a chiropractor, perpetuate bollocks that lines your pockets. Nice one
I have chronic pelvic pain and there are times when my SI joint gets painful and is stuck. However, I realize that it’s a chicken and egg dilemma because my pelvic PT would try and tell me that my SI stiffness is causing my pelvic pain but in reality I know it’s in the other direction. When my tissue sensitivity in my pelvis gets really high, I can feel the domino effect of my pelvic muscles starting to tighten. My pelvic PT can only Help me in a limited way. She mobilizes the tissue but because the nerve sensitivity is so strong, it just locks back up. Even if she could permanently loosen my joints and muscles it would only have a minor affect on the overall pain. I started incorporating fear reduction mechanisms into my life and the pain has changed for the better but I still have a long way to go.
This is a terrible message for physios and patients. You have ignored data by Damen et al 2001 Acta Obstet Gynecol Scand 80(11): 1019-24 and Buyrek et al 1999 Eur J Obstet Gynecol Reprod Biol 83 (2) 159-63 that shows that asymmetry of movement in the SI joints associates with PGP (not laxity in general, we agree on that). I had bad PGP that was fixed in a couple of sessions by a physiotherapist who restored said symmetry of movement in my SI joints. My PGP was not in my mind, and I find it insulting that you would state otherwise! Of course mental attitude plays a role in recovery, but taking research that shows this and extrapolating out to the conclusion that it is the only factor for recovery is poor science. Thank goodness I didn't see this when I still had PGP, I might still be struggling with pain thinking it was all my fault for not being mentally robust enough, and would not have experienced the sweet relief that came with good hands on treatment by a skilled physiotherapist. You do a disservice to women with PGP.
Pain-ed, can you reply on what you think of the data mentioned above?
@@ManjaWeijers yes please. I'd have my views on this also but would love to get feedback on this also
I M physiotherapist and this is shifting things for me. I would like to go on the course when its next in UK, Come to Liverpool!!! its great city haha ;0
Really love this kinda interviews and video's about the mind and the body. Learning a lot. Btw,Prof Peter O'Sullivan has intresting knowledge.
Have to say it is great to have these interviews to send to my patients to help back up my clinical reasoning that they don't need to do core stability exercises and help break up some sticky beliefs. Really helpful, thanks
So, so true. Once the TVA and psoas muscles become chronically tight, it causes a whole host of issues, telling someone to strengthen their core in that scenario is horrible advice. That's just one scenario where it's a bad idea too, i'm sure there are plenty more. I wonder why this become popular belief/advice, strange.
What a great message for physios and patients, Thank you Peter