Episode 53: Is surgery for pain a panacea or placebo? Things every clinician needs to know.

Summary In this episode, Bart Van Buchem and Tim Beames discuss the complexities of nociplastic pain, a relatively new classification of pain that arises from altered nociception without clear evidence of tissue damage. They explore the implications of this classification for clinical practice, the importance of understanding patient perspectives, and the cultural considerations that influence pain terminology. The conversation highlights the challenges of diagnosing nociplastic pain and emphasizes the need for a broader understanding of pain experiences, including psychological factors. They also touch on the upcoming science session featuring Jo Nijs, which aims to further explore these topics. Takeaways - Nociplastic pain is a significant and ongoing debate. - Understanding pain mechanisms is crucial for effective treatment. - Classification of pain can influence treatment decisions. - Patients often seek acknowledgment for their pain experiences. - Cultural factors play a role in how pain is classified and understood. - Pain experiences are often complex and multifaceted. - A broader perspective on pain is necessary for effective management. - Nociplastic pain challenges traditional pain definitions and classifications. - Psychological factors must be considered in pain management. - Upcoming discussions will provide balanced perspectives on pain classification. Topics nociplastic pain, pain classification, chronic pain, pain management, clinical practice, pain terminology, patient perspectives, cultural considerations, pain complexity, treatment implications Chapters 00:00 Introduction to Nociplastic Pain 05:59 Clinical Implications of Nociplastic Pain 12:05 Patient Perspectives on Pain Terminology 18:00 Complexity of Pain Experiences 23:55 The Future of Pain Management Recorded November 2024 Useful Links Le Pub Website: www.lepubscientifique.com  Become a Le Pub member: https://www.lepubscientifique.com/premium-membership  Contact us: [email protected] Follow us: Twitter: @lepubscientifiq Instagram: @lepubscientifique LinkedIn: @LePubScientifique

Summary In this episode, Tim Beames and Bart discuss the pervasive issue of misinformation in pain management. They explore how unhelpful messaging affects patients' understanding of their pain and the role clinicians play in addressing these misconceptions. The conversation emphasizes the importance of replacing misinformation with accurate knowledge, navigating uncertainty in patient care, and the need for clinicians to adapt their approaches based on individual patient experiences and beliefs. The episode concludes with reflections on the ongoing journey of learning and growth in clinical practice. Takeaways - Misinformation can significantly impact patient beliefs about pain. - Patients often filter information based on their experiences. - Clinicians must be aware of the emotional responses of patients. - It's crucial to replace misinformation with accurate knowledge. - Uncertainty in pain management can be challenging for both patients and clinicians. - Listening to patients validates their experiences and builds trust. - Challenging patient beliefs requires sensitivity and care. - The therapeutic process involves navigating complex emotional responses. - Learning and adapting are essential in clinical practice. - Building rapport with patients is key to effective communication. Topics pain management, misinformation, patient care, clinician responsibility, chronic pain, therapeutic process, patient education, emotional responses, uncertainty, learning Sound Bites "We need to counter misinformation." "It's about finding the balance." "We don't have all the answers." Chapters 00:00 Introduction and Setting the Context 03:13 Encountering Unhelpful Information 10:36 Replacing Unhelpful Information with Alternatives 14:38 Embracing Uncertainty in Pain Management 25:27 Compassion and Open-Mindedness in Countering Misinformation 30:45 Summary and Closing Remarks Useful Links Le Pub Website: www.lepubscientifique.com  Become a Le Pub member: https://www.lepubscientifique.com/premium-membership  Contact us: [email protected] Follow us: Twitter: @lepubscientifiq Instagram: @lepubscientifique LinkedIn: @LePubScientifique Recorded June 2024

Summary In this episode of the Pain Podcast, Bart Van Buchem and Tim Beames delve into the complexities of the quick fix mentality in pain management. They explore the implications of relying on immediate solutions versus the importance of long-term strategies for managing persistent pain. The conversation emphasizes the need for a mindset shift towards active participation in treatment, the balance between passive and active therapies, and the significance of building trusting relationships with patients to facilitate their recovery journey. Takeaways Quick fix mentality can be harmful in the long run. Patients often seek immediate relief from pain. Expectations play a crucial role in pain management. Active treatments can also serve as quick fixes. Mindset shifts are essential for long-term recovery. Empowering patients in self-management is key. Building trust with patients takes time. Celebrating small successes can motivate patients. Educating patients about the nature of pain is important. Relationships in therapy can lead to fulfilling experiences. Keywords pain management, quick fix mentality, chronic pain, active treatment, passive treatment, mindset shift, physiotherapy, patient empowerment, long-term recovery, self-management Chapters 00:00 Understanding Quick Fix Mentality 10:50 The Balance of Active and Passive Treatments 22:57 Shifting Mindsets for Long-Term Pain Management 32:50 Building Relationships in Pain Recovery Useful Links Le Pub Website: www.lepubscientifique.com  Become a Le Pub member: https://www.lepubscientifique.com/premium-membership  Contact us: [email protected]   Follow us: Twitter: @lepubscientifiq Instagram: @lepubscientifique LinkedIn: @LePubScientifique

Tim Beames and Bart Van Buchem discuss the myth around posture and pain. They explore the societal belief that bad posture causes pain and how this belief is often ingrained from childhood. They also discuss the influence of social media and marketing on the perception of posture. The conversation highlights the importance of exploring different postures and movements to find what feels comfortable and beneficial for each individual. They emphasise the need for positive language and experiential processes to help people change their posture and alleviate pain.   Keywords posture, pain, myth, bad posture, societal belief, childhood, social media, marketing, exploration, comfort, positive language, experiential processes takeaways The belief that bad posture causes pain is a societal myth that is often ingrained from childhood. Social media and marketing can influence the perception of posture and create unrealistic expectations. Exploring different postures and movements can help individuals find what feels comfortable and beneficial for them. Using positive language and experiential processes can be more effective in helping people change their posture and alleviate pain. Sound Bites "Sitting is the new smoking" "Your next position is your best position" "Just touch the back of your seat and see what's happening" Chapters 00:00: Introduction and Common Beliefs about Posture and Pain 11:10: Influence of Social Media and Marketing on Posture Perception 25:04: Positive Language and Experiential Processes for Posture Change   Useful Links Le Pub Website: www.lepubscientifique.com  Become a Le Pub member: https://www.lepubscientifique.com/premium-membership  Contact us: [email protected]   Follow us: Twitter: @lepubscientifiq Instagram: @lepubscientifique LinkedIn: @LePubScientifique

In this episode, Bart and Tim discuss the importance of taking a break from therapy and how it can benefit patients. They share a story of a patient who experienced positive changes after giving themselves permission to have a break. They explore the concept of embodiment and how being in a different environment can change the way we experience our bodies. They also discuss the therapeutic approach to breaks and the importance of empowering patients to take control of their own recovery. Overall, they emphasise the opportunity for reflection, exploration, and self-care that a break can provide.   Takeaways Taking a break from therapy can be beneficial for patients, allowing them to reflect, explore, and take control of their own recovery. Being in a different environment can change the way we experience our bodies and can provide opportunities for growth and self-discovery. Therapists should empower patients to take breaks and give themselves permission to rest and recharge. Breaks can be a time for reflection, evaluation, and planning for future self-care and well-being. The therapeutic approach to breaks should focus on creating a context that reinforces positive experiences and allows for mindful exploration. Chapters 00:00 Introduction and the Topic of the Day 02:26 The Importance of Self-Treatments and Productivity Pressure 09:44 Exploring Embodiment and the Impact of Different Environments 16:18 Creating a Context for Positive Experiences and Mindful Exploration 21:54 Empowering Patients to Take Control of Their Recovery 23:12 Conclusion and Announcement of the Pain Pub Quiz   Useful Links Le Pub Website: www.lepubscientifique.com  Become a Le Pub member: https://www.lepubscientifique.com/premium-membership  Contact us: [email protected]   Follow us: Twitter: @lepubscientifiq Instagram: @lepubscientifique LinkedIn: @LePubScientifique

Tim and Bart dive into the challenge of working under time constraints in both public health systems and private practice. They share strategies for setting boundaries, prioritising patient rapport, and delivering high-quality, individualised care despite limited time. The duo discuss the pros and cons of working within a system versus private practice and emphasise the importance of flexibility and challenging the status quo. Packed with practical advice and relatable anecdotes, this episode will help you conquer the clock and thrive in any clinical situation.    Useful Resource A Clinician's Guide to Thriving Under Time Constraints by Le Pub Scientifique & Sandy Hilton. Get your copy now: https://www.lepubscientifique.com/guides   Keywords time constraints, clinical practice, expectations, boundaries, flexibility, individualisation, protocols, efficiency   Takeaways Setting expectations and boundaries is important in managing time constraints in clinical practice. Flexibility and individualization are key in providing effective treatment within limited time. Protocols can be helpful for efficiency, but it is important to adapt them to suit each individual. Doing things well and making the most of the available time is crucial in providing quality care. Sound Bites "Setting out expectations and boundaries is really important." "Therapy starts when the patient leaves the room." "The ability to adapt protocols to suit each individual is a skill." Chapters 00:00 Introduction and Overview 02:22 Whose Problem is Time Constraints? 04:18 Time Constraints in Different Contexts 06:41 Creating a Treatment Plan 09:07 The Challenge of Making a Difference in Limited Time 13:29 The Therapy Continues Outside the Room 15:23 The Importance of Readiness to Change 20:38 Private Practice vs Public Health System 23:23 Flexibility and Choice in Private Practice 25:45 The Value and Limitations of Protocols 28:09 Managing Time Constraints and Asking the Hard Questions 30:09 Doing Things Well in Limited Time Useful Links Le Pub Website: www.lepubscientifique.com  Become a Le Pub member: https://www.lepubscientifique.com/premium-membership  Contact us: [email protected]   Follow us: Twitter: @lepubscientifiq Instagram: @lepubscientifique LinkedIn: @LePubScientifique

Professor Cormac Ryan delves into the transformative power of the Flippin' Pain campaign, a groundbreaking initiative dedicated to revolutionising the way people think, talk, and treat persistent pain. Through the lens of this public health approach, Cormac explores the critical importance of sharing knowledge, empowering communities, and harnessing the power of lived experiences to bridge the gap between specialists and the vast number of individuals living with persistent pain. Discover the six key messages that lie at the heart of this movement and learn how, by challenging misconceptions and reframing the narrative surrounding persistent pain, Flippin Pain is paving the way for a brighter future where recovery is possible, and no one is left to suffer in silence.   Keywords persistent pain, knowledge, Flipping Pain, public health, generalists, biopsychosocial approach, lived experience, communication, recovery, expectations   Takeaways The Flipping Pain initiative aims to boost knowledge and understanding of persistent pain in society. Reaching generalists who interact with patients on a daily basis is crucial for disseminating accurate pain-related knowledge. The campaign focuses on changing the way people think, talk, and treat persistent pain, promoting a biopsychosocial approach. The lived experience of pain is a vital component of the campaign, providing relevant and powerful perspectives. Barriers to spreading accurate pain-related knowledge include competing messages and the need to lift expectations and be more optimistic about recovery. Sound Bites "Flipping pain is about trying to change understanding on a community level, on a public health level about persistent pain." "We need to take the best strategies from marketing and for communication and utilize those in our endeavors to try and communicate a better understanding of persistent pain." "Recovery is possible. That's it, actually how I greet the person coming in." Chapters 00:00Introduction and Overview 01:18The Need to Share Accurate Pain-Related Knowledge 08:13The Six Key Messages of Flipping Pain 18:07Overcoming Barriers to Spreading Accurate Pain-Related Knowledge 21:52Lifting Expectations and Being Optimistic About Recovery 30:35Conclusion and Call to Action   Useful Links Le Pub Website: www.lepubscientifique.com  Become a Le Pub member: https://www.lepubscientifique.com/premium-membership  Contact us: [email protected]   Follow us: Twitter: @lepubscientifiq Instagram: @lepubscientifique LinkedIn: @LePubScientifique

Tim Beames and Bart discuss the debate surrounding surgery for pain. They explore whether surgery is a panacea or a placebo, and share their thoughts on the topic. They discuss the influence of influential figures like Elon Musk and Tiger Woods, as well as the role of surgery in treating neurological problems. They also touch on the importance of a balanced approach and the need for clinicians to inform patients about the potential risks and benefits of surgery. Keywords surgery, pain, panacea, placebo, debate, neurological problems, Elon Musk, Tiger Woods, success, immune system, inflammation, research, bias, placebo surgery Takeaways The debate surrounding surgery for pain is complex, with no definitive answer as to whether it is a panacea or a placebo. Surgery can be effective for treating neurological problems, but its efficacy for pain alone is less clear. The success of surgery can vary depending on individual circumstances and the underlying cause of the pain. Clinicians should inform patients about the potential risks and benefits of surgery and help them make an informed decision. There is a need for more research and high-quality studies on the effectiveness of surgical procedures for pain. Chapters 00:00 Introduction and Recap 01:35 Elon Musk's Statement and Initial Thoughts 07:11 Surgery for Neurological Problems 09:19 The Role of Clinicians in Informing Patients 13:12 The Potential Effects of Surgery on the Immune and Inflammatory Systems 23:02 The Need for More Research on Placebo Surgery 29:36 Summary and Closing Remarks   Useful Links Le Pub Website: www.lepubscientifique.com  Become a Le Pub member: https://www.lepubscientifique.com/premium-membership  Contact us: [email protected]   Follow us: Twitter: @lepubscientifiq Instagram: @lepubscientifique LinkedIn: @LePubScientifique        

In this episode, Tim talks to the acclaimed osteopath and PhD candidate, Alison Sim about her research on preventing chronic pain after injury, particularly in the context of compensable care. Alison discusses the stressful and distressing nature of the compensation claim process, which can significantly impact recovery. Her research reveals an overlap in frustrations experienced by both claimants and clinicians, particularly regarding delays in care and lack of support. Alison's team developed a beneficial 5-session telehealth intervention based on co-design workshops with claimants. Interviews with experienced clinicians highlighted a common pattern of initial feelings of being underskilled, seeking further education, and ultimately developing a sense of mastery in their role. Alison suggests improvements to the compensation system, including early access to high-quality care and streamlining the claims process. Her research emphasises the importance of addressing psychosocial aspects of injury recovery in compensable care settings to foster better outcomes for individuals.   Keywords chronic pain, compensable care, claims process, early interventions, pain self-management, social support, clinician experience, complexity, uncertainty   Takeaways The claims process in compensable care can be distressing for both claimants and clinicians, and it is a significant predictor of poor outcomes. Early interventions that provide information about the claims process, pain self-management strategies, and social support can help improve outcomes for claimants. Experienced clinicians working in compensable care can find fulfillment and a sense of mastery in managing complexity and uncertainty. Improving access to high-quality care, enhancing communication skills, and providing support for both claimants and clinicians are essential for better outcomes in compensable care. Further research and evaluation are needed to assess the impact of interventions and systemic changes in compensable care. Sound Bites "I am interested in looking at early interventions to prevent the development of chronic pain following injury and particularly interested in injury in the setting of compensable care." "The distress of interacting with the processes required to engage with a claim is a big predictor of poor outcomes." "People didn't understand the claims process and felt overwhelmed by it." Chapters 00:00 - Introduction and Background 02:07 - PhD Research on Early Interventions in Compensable Care 08:19 - The Distressing Nature of the Claims Process 11:16 - Intervention: Providing Information, Self-Management Strategies, and Social Support 29:18 - Improving Outcomes in Compensable Care   Useful Links Le Pub Website: www.lepubscientifique.com  Become a Le Pub member: https://www.lepubscientifique.com/premium-membership  Contact us: [email protected]   Follow us: Twitter: @lepubscientifiq Instagram: @lepubscientifique LinkedIn: @LePubScientifique Join the Le Pub Community on Facebook: Le Pub Scientifique 

Tim and Bart dive into the world of pain science and uncover the truth behind common misconceptions in their brand-new podcast series, The Painful Truth. With their signature blend of expertise, humour, and compassion, Tim and Bart tackle the most pervasive ideas surrounding pain care and treatment head-on. In this inaugural episode, they take on the popular notion that you "can't go wrong getting strong" when it comes to managing chronic pain. But is this advice as straightforward as it seems? Tim and Bart explore the nuances and potential pitfalls of applying this mantra to everyone, shedding light on the importance of personalised approaches to pain management. They share valuable insights on the complex relationship between strength training and chronic pain, the psychological impact of pain, and the risks of one-size-fits-all exercise prescriptions. You'll come away with a deeper understanding of what it takes to effectively manage chronic pain and why a multifaceted, individualized approach is key. Whether you're living with chronic pain, supporting a loved one, or simply interested in the latest pain science, this episode is a must-listen. Tune in to The Painful Truth and join Tim and Bart on an enlightening journey towards better understanding pain, strength, and the path to improved well-being. Useful Links Le Pub Website: www.lepubscientifique.com  Become a Le Pub member: https://www.lepubscientifique.com/premium-membership  Contact us: [email protected]   Follow us: Twitter: @lepubscientifiq Instagram: @lepubscientifique LinkedIn: @LePubScientifique Join the Le Pub Community on Facebook: Le Pub Scientifique