Hello all.

The title explains a lot. I’m in my second year of practicing. Right out the gates I didn’t delve into this topic (although I knew it existed) because I wanted to get confident as a practitioner. I practiced for a year, went on maternity leave, and eight months later am slowly emerging back into practice. I’ve been catching up on pain science, and feel like I just don’t know how to assess a patient anymore. No postural assessment, ever? Or just with athletes? Is AROM and PROM valid? What about the special orthopedic tests? Or do we abandon it all and just focus on motivational interviewing and helping people to ‘be with’ their pain, and educate on pain science and the medicine of movement? Or continue with postural assessments just to have a baseline, but don’t tell the patient anything about their posture to not make them feel bad?

Anecdotally, I usually focus on pelvic mechanics, and have found from correcting misalignments that people feel better. Is it just as much becuase they are confident in my ability to assess and treat them that they feel better as it is about the technique im using?

As I mentioned, maternity leave, so new mom status, I don’t have a tonne of time to read countless articles, hence why I’m here, however, if you have some to share, please do so!

Thanks for reading.

if i feel pain at the beginning of a workout, but as i warm up the pain goes away completely, is that okay, or should i have stopped as soon as i felt pain?

Having this conversation rn

Greetings, fellow warriors of the injured shoulder club! It has been a whopping 9 weeks since I embarked on my Reverse Total Shoulder surgery journey, and boy, what a ride it has been. Let me fill you in on the ups and downs of my recovery process.

First things first, I triumphantly bid farewell to the realm of couches and began sleeping in the heavenly embrace of my own bed after 3 weeks of post-op rest. Admittedly, I still don a sling when I venture out into the world, but hey, safety first, right? In fact, I even treated myself to a fancy lightweight sling for those sweet dreams. Who says fashion and recovery can't go hand in hand?

Now, the moment we've all been waiting for: the glorious check-up with my doctor. Drumroll, please! Guess what? I've been granted the freedom to break free from the clutches of the sling during my everyday errand runs. However, I play it safe when it comes to driving, sticking to short distances to avoid any unnecessary shoulder shenanigans. After all, patience is the name of the game, and this healing process is no sprint—it's more like a marathon spanning anywhere from 6 months to a year for a full recovery.

Sure, my pain level is normal, but let's talk about the discomfort, shall we? It's like having a grumpy passenger on this journey, constantly reminding me not to overdo it. I still can't quite reach behind my back, which is both frustrating and slightly scary. I mean, I certainly don't want to pull a superhero move and reinjure myself. Safety caution: engaged!

But fear not, dear readers, for I am not alone in this battle. Therapy sessions have become a regular fixture in my life, three days a week to be precise. Let me tell you, it's going swimmingly. The key to success? Staying committed to those home exercises. Trust me, with every passing fortnight, I feel a whole lot better. So, folks, remember to stay positive, even when that shoulder feels as heavy as carrying a sack of potatoes.

The good news is that my range of motion is gradually improving. However, I can't stress enough the importance of caution when I dare to venture out without my trusty sling. I've bid farewell to the ice pack brigade, as it simply lost its charm and effectiveness. Instead, my doctor swooped in to save the day, issuing me some inflammation meds to tackle the swelling and discomfort. Huzzah for modern medicine!

Now, here's where things get really exciting—gym time, baby! Well, sort of. I've been easing myself into the gym routine, focusing on super light weights to gradually build up strength in my upper back muscles and indulge in some arm curls. Doc says I can conquer those machine weights, but alas, pull-ups are a big no-no for now. Patience, my friends, patience. My primary goal? Tackling that saggy chest situation caused by the lack of workouts. So, it's cardio, row machines, and leg workouts galore!

In the end, I'm just genuinely grateful that I underwent this transformative surgery. It's given me hope, strength, and a newfound appreciation for the healing process. So, fellow shoulder warriors, let's stay united on this path to recovery. Remember, we're all in this together, one sling-free step at a time.

Stay tuned for more tales from my shoulder escapades. Until then, keep fighting the good fight, and never forget to celebrate the small victories along the way!

Yours in shoulder solidarity,

How come whenever I have pain in just one part of my body, like my left arm, it completely takes me out?

I’ve been bedridden for the past few days and I have finals that I need to study for but I have too little energy to even chew food (not that I was much of an eater beforehand, but still) not to talk of getting out of bed and engaging in course material at my desk. I’m trying to cope by just watching YouTube videos.

anyone here studying bone pain?

I’m currently doing a course in neuroscience and it has sparked my interest in pain science :) i know there are many books but not sure which ones are good - if anybody has any recommendations please let me know!

Do you have a chronic painful condition (e.g., fibromyalgia, low back pain, rheumatoid arthritis, IBD)? Are you 18+?

We are seeking participants for a study measuring physical activity and personal factors (e.g., body connection, self-esteem). The online survey will take about 20 minutes to complete. If you have a chronic painful condition, we would greatly appreciate your participation.

Please click here for more information or to take part https://www.surveymonkey.ca/r/FG3HCZS

If you have questions about taking part or would like to discuss the study further, please contact Hannah Hube, research assistant: Hannah.Hube@mytwu.ca.

Very exciting result for the field of neurophysiology and pain science from the Nobel committee today. The function of TRP and PIEZ0 receptors was at the core of my pain science education, and am really vicariously pleased for Dr Julius & Dr Patapoutian to be recognised for their incredible work in developing our knowledge of touch, heat, cold and pressure.

However, I kept reading that "these findings raise novel and exciting approaches for the treatment of chronic pain". I'm a psychologist by training, and my (limited!) reading over the years has mostly found that TRPV1 agonists (capsaicin mostly) and antagonists provide limited/mild relief for patients and generally it's highly varied and has a lot of odd side-effects. Does anyone out there have any thoughts on the prize, their work or the future implications for these findings? Am really curious to see what people think.

Without doubt, their work has vastly advanced our knowledge of pain. Congratulations to them, their lab members and collaborators

​

https://www.bbc.co.uk/news/health-58787438

https://www.nature.com/articles/d41586-021-01283-6

Any pain science resources for migraine pain?

Do you have a chronic painful condition (e.g., fibromyalgia, low back pain, rheumatoid arthritis, IBD)? Are you 18+?

We are seeking participants for a study measuring physical activity and personal factors (e.g., body connection, self-esteem). The online survey will take about 20 minutes to complete. If you have a chronic painful condition, we would greatly appreciate your participation.

Please click here for more information or to take part The Physical Activity and Chronic Conditions Study Survey (surveymonkey.ca)

If you have questions about taking part or would like to discuss the study further, please contact Hannah Hube, research assistant: Hannah.Hube@mytwu.ca.

I have been reading some stuff about how pain is more than just "injury hurts while it's healing", and it's all really interesting. I have been wondering how applicable all this stuff is to sickness (nausea, and specifically motion sickness)? In terms of either research, or just logically from what we know about various things.

1. I have come to understand that just being in pain can actually cause it to become a sortof habit in the brain and make you more "sensitised" to it. Does this apply to sickness, for example, would feeling nauseous for a whie then mean you would get it at a lower threshold in the future, or that you would get motion sickness quicker in a car for example?

2. I have a generl intrest in gaming, and one thing I have seen repeated a few times in the gaming commnunity, and specifically VR, is this idea that if you get motion sickness when using a VR headset for the first time, you should never, ever, push through it even slightly, as it can develop an accosiation between the headset and sickness that can be hard to break. Obviously I can imagine this could be due to anxiety around it, however is there any other basis for this? As it seems ot go against this common idea that people get used to being on a boat and after a few days of feeling a bit nauseas, start to feel okay.

Also, anm extra more general question about pain:

3. If we become more sensitive to pain when we have it for a while, how come peole with chronic pain conditions don't just gradually get worse and worse and worse, as the pain reinforces itself and becomes even more severe? I know some people may have this but there are plenty of people who either get better or just stay the same for long periods of time.

Not the first time it happened, but its very rare. I hold a cold wet towel to each eye and the burning goes away after a bit.

Is it cancer or something?

I have been doing a bit of research about pain and specifically forms of sensitisation (I think central sensitisation is the one I have been reading about most). I thought I would put all these questions in one thread as they are all fairly short, as you can probably tell I'm no expert on any of this stuff, just a curious layman really.

1. Can central sensitisation cause people to experience "feeling sick" more easily? i.e. can it make someone more susceptible to motion sickness? And if it can, would this happen only when the cause was someone being persistently motion sick, or could any central sensitisation cause this?

2. From what I have read I understand that central sensitisation causes existing pain to be worse and stuff that previously didn't cause pain to start causing pain, I assume both of these things have to happen, as they are basically the same, and you can't just have one?

3. If the sensitisation isn't actively causing pain in someone, as it just isn't bad enough yet, will it fade over time, or does it never get better in a patient unless directly treated?

4. I have read exercise can decrease your level of sensitisation, is this correct?

(Links to scholarly sources only please!)

When it comes to a lot of pain, it seems like a lot of it is central sensitisation type stuff. When I read about this they always list various treatments, however is it true that the treatment for this won't really work on everyone? Does this mean some people just get stuck with pain that isn't even caused by a physical thing, but are completely unable to get rid of it?

What do you think? Do you think the future could offer us some promising solutions within 10-20 years?

I have been reading about how chronic pain can develop, and about central sensitization and peripheral sensitization.

I'm new to this so I'm not very sure about the terms, but as far as I understand, central sensitization is when there is a dysfunction in the brain that can cause pain everywhere, and peripheral sensitization is when it is just in the affected nerves and only causes pain there?

I have a few questions about this, as to how this can impact people with injuries etc:

1. Does central sensitization need to be "kick started", or is it always happening to an extent whenever an individual has an injury and "works through it", or does the person need to push through it for a certain amount of time before the process even begins?

2. Can Psychosomatic pain caused by stuff like anxiety cause this sensitization in the same way that "actual" (as in from an injury) pain does?

3. I have read that there are two different types of central sensitisation, one where it gets worse only from doing a painful activity, and another where it can get worse without doing a painful activity? Is this true?