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Join co-hosts Sandy Hilton and Cory Blickenstaff, physical therapists who are "in the trenches" practicing in unique settings on opposite sides of United States, as they discuss current research and topics of pain science. Listen in on occasional interviews of the prominent figures of pain science. Focus will be on making the information meaningful to practice in the clinic.
 
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show series
 
Sandy and Cory discuss a recent paper that did not find an effect of providing education with therapeutic alliance in a chronic low back pain population. Does that settle the question of whether establishing a therapeutic alliance is worthwhile, or is there more to it? Of course there's more to it. Listen in on the conversation and see if you agree…
 
In this episode, Sandy and Cory take a look at this popular publication from 2019 proposing an "Enactive Approach" to pain. There's a lot to cover in this paper as it takes us through a history of pain science up to the Biopsychosocial model at which point it proceeds to point out some flaws in the model. GASP! Take a listen as the discussion unfol…
 
Pain flare-ups are one of the most frustrating things for patients and clinicians alike. Are they normal? Who gets them? Why is it important to know their prevalence? What are Sandy and Cory's thoughts on dealing with them? All this and more in episode 50! Prevalence, Severity, and Correlates of Pain Flares in Response to a Repeated Sit-to-Stand Ac…
 
We are joined in this episode by Professor Lorimer Moseley AO for a casual chat about pain. Lorimer gave us his thoughts on recent and future clinical research and the translation of the evidence into the clinic. Is there an expiration date for recovery from persistent pain? How can we enhance learning the things that matter? Was it a mistake to th…
 
Do you use SI joint tests? What type of information do the tests give you? Should you be using them? These are just a few of the questions that arise in the discussion of this recent perspective paper. Join us for episode 48! Changing the Narrative in Diagnosis and Management of Pain in the Sacroiliac Joint Area. Palsson TS, Gibson W, Darlow B, et …
 
Is it safe to exercise and lift heavy things for people with pelvic organ prolapse symptoms? Or put more bluntly, will lifting heavy weights make your lady bits fall out? Is lifting weight asking for trouble? That is the question that our guest this month is seeking to answer and Sandy and Cory sit down to ask some questions about her recently publ…
 
These questions arise very frequently in rehabilitation. Should it hurt? Is it OK if it hurts? Will I set myself back if it hurts? Will I get better if it doesn't hurt? In this episode we examine a pair of articles that examine these questions. One article is an RCT that covers pain free vs. painful exercise in an acutely injured population, while …
 
A recent Cochrane review looked at studies of people with rotator cuff tears comparing those who had surgery with those who did not. What do you think they found? Did surgery provide benefit? Is it OK to go without surgery in these cases? Sandy and Cory discuss these findings and provide their clinical commentary in this episode of Pain Science and…
 
This episode covers a recent paper that compares a popular and trending approach, Cognitive Functional Therapy, against a group treatment and exercise intervention. The primary outcomes were pain and disability. The results may surprise you. Join Sandy and Cory as they discuss the findings, what to make of them, and the clinical impact. Cognitive f…
 
In the last episode (42) a systematic review was discussed regarding the value of pre-operative measures in predicting pain post-operatively. In this episode, Dr. Henrik Vaegter, an author of that review joins us to discuss that research as well as several other fascinating topics regarding exercise and pain. In this interview we discuss topics of …
 
In this episode Sandy and Cory discuss a systematic review which investigated what pre operative pain tells us about a person’s propensity for post operative pain. Is it predictive? If so, would changing it matter? The discussion gets into these topics and more. Are preoperative experimental pain assessments correlated with clinical pain outcomes a…
 
This study looked at pain score associations between people with "typical" and "atypical" bedtimes. Sandy and Cory discuss the topic of sleep and pain broadly as well. So, perk up and see if you can make through this episode without dozing off. Does bedtime matter among patients with chronic pain? A longitudinal comparison study. McHugh RK, Edwards…
 
In this month's episode we are examining more of a general health question. But it is one that is very relevant to people in pain. Much has been made of "Sitting is the new smoking" with some indications that the negative effects of sitting may not be able to be undone with exercise and activity. This study looked at that concept in particular. Joi…
 
This paper, with results that many find very surprising, has started a bit of a buzz in the PT world. What do we make of the results? Can we trust the results? What does this mean in clinical practice? We were able to discuss these topics and more with the researchers themselves as Adrian Traeger and James McAuley were kind enough to share their ti…
 
Research on chronic pain tends to aim at identifying factors that are in deficit, or are the so called "risk factors" for those who develops chronic pain. In this episode, we discuss a paper that takes a different angle in looking at what factors do those people who are successfully living well with chronic pain share. The primary author is friend …
 
That's right everyone! It's that time of year again! All the PT Podcast Network voices (except for Adam) have gathered together to bring you some podcast holiday cheer! This very special episode is brought to you by My PT Insurance. Head on over to their website at myptins.com/ptinquest to be entered into a drawing for a $250 Amazon gift card (cont…
 
That's right everyone! It's that time of year again! All the PT Podcast Network voices (except for Adam) have gathered together to bring you some podcast holiday cheer! This very special episode is brought to you by My PT Insurance. Head on over to their website at myptins.com/ptinquest to be entered into a drawing for a $250 Amazon gift card (cont…
 
This episode covers a recent meta analysis looking at differences in brain patterns when an expectancy violation, thought to be important in effectiveness of exposure based therapies (see episodes 12, 15, and 31), occurs passively versus actively. Active expectancy violation is thought to be more likely to bring about a change in behavior. This res…
 
In this episode, Sandy and Cory discuss a recent paper proposing a "Mechanism Based approach to physical therapy management of pain." This paper proposes 5 mechanisms to consider when managing people in pain and how some common PT interventions may impact these mechanisms. The discussion goes into some of the details of these proposals as well as s…
 
How much of an improvement would you need to see in order to feel that physiotherapy was going to be worthwhile for your low back, neck, or shoulder pain? This is the question that this study examines and that is discussed in this episode. Also Sandy considers opening a steak restaurant. The smallest worthwhile effect of primary care physiotherapy …
 
In this episode the topic of pain memory recall is explored. How well do we remember our past pains? Are there differences in recall between populations? What might account for the differences when they occur? All of these topics covered in episode in which Sandy and Cory discuss a recent research article on the topic. Hippocampal morphology mediat…
 
In episode 33, Sandy and Cory are joined once again by Pain Specialist Physician, Milton Cohen. Dr. Cohen and his group have submitted a new clinical definition of pain. In the discussion, we unpack the new definition term by term and discuss issues that Dr. Cohen and his group have spelled out regarding the current and famous IASP definition. Does…
 
A recent paper looks at the philosophical underpinnings of the practice of mindfulness and raises some concerns regarding the ethics of its use. In this episode, these concerns are discussed as well as the larger implications of informed consent and respect for patient values. Forgetting ourselves: epistemic costs and ethical concerns in mindfulnes…
 
We return to exposure based therapy and an update of the topic covered in the popular episodes 12 and 15, expectancy violation. This time we discuss a clinical commentary paper reviewing the state of the evidence related to the claims of Craske et al. How have the claims held up? What is the state of the science on the topic? This and more in episo…
 
Our guest in this episode is Dr. Nortin Hadler, a rheumatologist and professor of medicine at the University of North Carolina in Chapel Hill, who has spent decades right in the middle of several health care debates. Dr. Hadler, or as Sandy likes to call him "Quote Machine," spent an hour with us reflecting on a range of topics. What is medicalizat…
 
This episode has Sandy and Cory discussing a recently released book, tilted Meanings of Pain. Can we measure pain? What is the impact when we try? How do the roles we assume impact the care we provide and how it is received? Listen in as our hosts consider these and other topics that have been raised by this very interesting and comprehensive book.…
 
In this episode of Pain Science and Sensibility, it’s another British Invasion! So, I guess that would make us the Ed Sullivan show? Special guest Adam Meakins, host of the NAF physio podcast, joins us for a discussion regarding his proclamation that “Manual Therapy Sucks.” His provocative stance has stirred a lot of attention and discussion. So, s…
 
Sandy and Cory discuss a popular topic in the treatment of low back pain; the role of the transverse abdominus. This paper examines the role in pregnancy related low back pain but the episode goes on to discuss the topic more broadly. Now suck in that naval and listen along! The transverse abdominal muscle is excessively active during active straig…
 
What is stratified care? Can we get the right patients to the right care at the right time? In this episode we look at a study examining some of the background required to answer these questions. Can we predict who is at risk for developing persistent pain? If we can then we might be better able to direct them to the right care. The findings may su…
 
Episode 25 has our hosts, and special guest Kelly Newman SPT discussing a recent review article comparing 3 of the major clinical guidelines for the treatment of low back pain. What is a clinical guideline? How are their recommendations established and why are there differences between them? What is "the burden of proof" and why is it relevant to t…
 
Special Guest Milton Cohen MD, Rheumatologist/Specialist Pain Physician, joins the show to discuss a variety of topics in this far ranging interview. Dr. Cohen and his research group has written extensively on topics ranging from critical appraisals of the biomedical and biopsychosocial framework to the nature of the therapeutic interaction. In the…
 
Episode 23 has Sandy and Cory discussing a review article about modeling pain using a Bayesian statistical model. Fear not! You'll not need an abacus to follow along as the discussion moves from considering the model to potential use and problems with the "Bayesian Brain" concepts that are currently en vogue. What is the big deal with Bayes theorem…
 
Episode 22 has Sandy and Cory discussing a systematic review on whether biases are present in healthcare decisions and if so, do they have a negative impact. Are biases something that we need to worry about? Is Cory a robot? Also, Sandy coerces her DPT student Christa Wolf to join the show for an important perspective from the student side. Take a …
 
In this episode, Sandy and Cory are joined by special guest Roderick Henderson who is a physical therapist and strength coach. The group reviews a recent article on the impact of aerobic exercise on pain sensitivity and also goes on to talk about several topics concerning strength and conditioning aspects of care for people in pain. How much should…
 
In episode 20 Sandy and Cory discuss an exploratory research paper on Sandy's area of expertise, pelvic pain. The presence or absence of neuropathic pain in this population is not well known and Sandy provides some insight into how this gap along with some common misconceptions play out in unfortunate ways for patients with these presentations. Cor…
 
The PT Podcast Network crew are here to spread some holiday cheer with the annual PT Podcast Network Extravaganza! They talk Jedis, rectums, Festivus, and horrible jet lag - all the holiday standards. Some say it's unlistenable...but you get to judge for yourself! Music for The PT Podcast Holiday Extravaganza: Kevin MacLeod - incompetech.com…
 
Cory and Sandy continue their search for clinical excellence (and interesting new screening tools), including an in-depth look at the benefit of using pain drawings as part of clinical assessment. Can these drawings be used to indicate signs of central sensitization? If not, are they useful anyway? How excited is Cory about the Cubs in the World Se…
 
In episode 17, Sandy and Cory attempt to tackle a difficult theoretical paper (difficult for non-neuroscientists, at least) discussing some potential implications of interoception in chronic pain. The discussion wades into "embodied cognition" and "predictive processing" among many other models that this paper attempts to cover. Also, we uncover th…
 
In this episode Sandy and Cory discuss a recent RCT in which a CBT approach was applied to the workplace. Cory works in the occupational setting and so is able to offer some insight into how this type of care might be provided. The discussion goes in some interesting directions as both of our co-hosts feel that there is application for these findin…
 
In this special episode of Pain Science and Sensibility we are co-releasing with the Naked Physio Podcast, joining up with Paul Lagerman and Bronnie Thompson (who you may remember was also a special guest on Episode 11) to revisit and expand thoughts on the Inhibitory Learning paper from Episode 12. Listen in as Sandy and Cory learn that their inve…
 
In episode 14, Sandy and Cory take on a Cochrane review looking at trunk motor control exercises for low back pain and another paper comparing specific exercise vs. just walking in low back pain. The findings may surprise you. As a special treat, guests Mike Stewart of "Know Pain Mike" fame, and Andrew Rothschild join in for the clinical applicatio…
 
We're talking about pelvises (or is it pelvi?) on episode 13! We discuss a specific paper that is both specific to pelvic pain and highlights some controversies that are more general in pain science. This is in Sandy's wheel house and she doesn't disappoint as she walks through some clinical applications while Cory tries to compensate for his disco…
 
In this episode of Pain Science and Sensibility Sandy and Cory dive into some specific applications of Graded Exposure some of which are very surprising and may have some astounding implications for what we do with our patients. Are we accidentally encouraging "safety behaviors" that may negatively impact progress? When is the best time to educate …
 
In Episode 11 Cory and Sandy get pedantic about the definition of "function" vs "activity" and are joined by a surprise guest when Dr. Bronwyn Thompson wanders by. Sandy learns another tool for helping her patients with sleep challenges and we get to nibble on a muffin and sip coffee while Bronnie teaches us some Kiwi words and a different perspect…
 
In Episode 19 we chatted with one of the hosts of The Pain Science and Sensibility Podcast, Sandy Hilton. Here on Episode 21, we talk to the other host Cory Blickenstaff. Cory works in a private practice in Vancouver, WA. He has presented nationally on topics related to treating pain as well as work site industrial care delivery models. He authored…
 
In this episode, Sandy and Cory discuss the popular treatment method of neurodynamics. While discussing a recent RCT which used the method in a group of patients with a fibromyalgia diagnosis the hosts also go in to some depth of how they use neurodynamics in the clinic. Also, Sandy's secret mission to convince Cory that he's a pelvic health therap…
 
How do you know if a mouse feels pain? Not to spoil the surprise, but it involves being stuffed head first into a glove. What might this mean for us larger animals? In this episode, Sandy and Cory discuss an animal study article which examines the role of exercise and pain. Grab a beverage and pull up your hamster wheel for Episode 8!…
 
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