This is part two of a shared blog from Jay-Shian Tan and Kevin Wernli, two PhD students at Curtin University who were invited to attend the recent EP3 at the G as science correspondents. Part 1 ‘Integrating Explain Pain and Cognitive Functional Therapy in persistent low back pain‘ can be found here.

*This is my interpretation of how Russell went from a fearful, anxious person with a 35-year history of back pain, to someone with a new mindset on his back/life and hope for the future  – ‘a light at the end of the tunnel’ (a great example of a patients use of the metaphorical language that Jay discussed previously). This interpretation is based on my experience as a PhD candidate at Curtin University, my own research of Cognitive Functional Therapy, and my experience working in a Clinic with people like Professor Peter O’Sullivan, Dr JP Caneiro…

Reflections on EP3 at the G

I had the fantastic opportunity to be invited to attend EP3 at the G (Melbourne Cricket Ground) as a science correspondent. One of the standout learning experiences was due to the generosity of a gentleman named Russell who donated his time to stand on stage and be examined by Peter O’Sullivan in front of 250 people! Russell’s 35 year story exemplified the discrepancy between guidelines based care and clinical practice.

Evidence base in persistent low back pain

The recent Lancet series in low back pain described this gap between clinical practice and the recommendations promoted in best practice guidelines (Foster 2018). International guidelines in the management of people with persistent low back pain are aligning towards common themes that all health care professionals and the general community need to become familiar. Promoting high value care such as education, returning to usual activity, exercise and…

This November, I was fortunate to be invited to be a science correspondent at EP3 in Melbourne and hear David Butler, Lorimer Moseley, and Peter O’Sullivan speak about their experiences studying, treating, and teaching about pain. More than that, they told stories.

We are always looking for stories. Stories for our lives, for our work, for our future, for our past. These stories construct our identity, and they change, sometimes very slowly with much force and resistance, and sometimes so quickly and effortlessly that we wonder how the story could have ever been anything but what it is now. Change drives new stories, and stagnation cements them by retelling them over and over so that they become true.

“Patients are calling for story. If all they have is the negative story, that’s what they run with. Changing the way we talk about pain and disability is a very direct way…

Novellas?

Novellas are longish Explain Pain stories – they could take 5 -10 minutes or even longer. Patients can read them or perhaps therapists can construct a story from them. Lorimer and I have constructed 15 novellas in Explain Pain Supercharged, and here is the one I use most frequently.

Oldies are goldies  

Most of us are living longer! Sixty is the new 40, 80 the new 60 so we hear. Phew! Living longer is usually a good thing but ageism is in the air. Ageism is a negative perception of getting older and of older people. It’s a really big personal and societal DIM (Danger in Me neurotag) and it needs to be challenged. Young and old people can be ageist, older people can be ageist about themselves, health professionals and sometimes government departments and companies are ageist. Let’s challenge it, first by obliterating some myths about…

I don’t know where this memorable and marvellous metaphor came from but I have been using it since a post grad manual therapy degree in 1985. It seems to have spread around the world. When a patient leaves the clinic if motion is lotion is all they remember, then in many cases, it is probably an adequate summary of what I want them to learn. It implicitly links movement to health and it inspires healthy imagery – I think of coconut sunblock lotion and beaches!

Motion is lotion is an example of functional knowledge – ‘know how’ knowledge that an individual can use to inform action and change behaviour. But in order to offer functional knowledge to patients, therapists need a deep base of declarative knowledge, this is the more detailed, more technical understanding of a topic – you could also think of it as content, or the kind…

A good friend of NOI, Yannick Barde-Cabusson has previously translated our DIM SIM NOInote into French – Les DIMs et les SIMs. Yannick has now translated a number of classic NOI infographics and has written a series of blog posts to go with them – here he is in his own words with a piece on the Twin Peaks Model. If you are a French speaking NOIjam follower, please enjoy, if not, you may have a friend who is, that you could share this with. Our thanks to Yannick for his work.

Le « Twin Peaks Model » (voir la figure ci-dessous) tiré du livre « Explain Pain* » est un modèle poursuivant plusieurs objectifs d’éducation thérapeutique à la douleur. Il peut permettre au patient de découvrir que douleur et dommage tissulaire ne sont pas nécessairement liés ou encore comprendre comment son système nerveux (SN) s’est sensibilisé et utilise la douleur pour le…