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Episode 30: I am a Placebo: An Interview With Dr. Nortin Hadler, MD

Pain Science and Sensibility

Release Date: 12/28/2017

053 Is Therapeutic Alliance a Bust? show art 053 Is Therapeutic Alliance a Bust?

Pain Science and Sensibility

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 with our take. Miyamoto GC, Fagundes FRC, de Melo do Espírito Santo C, et al. JOSPT. 2021 Aug;51(8):392-400. doi: 10.2519/jospt.2021.9636. Epub 2021 May 7. Music by Kevin MacLeod – : Intro – Brandenburg No4 and Meatball Parade Close...

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052 Beyond the BPS Model? show art 052 Beyond the BPS Model?

Pain Science and Sensibility

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 unfolds. Peter Stilwell & Katherine Harman. Phenomenology and the Cognitive Sciences. 18, pages637–665(2019). doi: 10.1007/s11097-019-09624-7. Music by Kevin MacLeod - : Intro - Brandenburg No4 and Meatball Parade Close - Meatball Parade

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2020 PT Podcast Network Holiday Extravaganza show art 2020 PT Podcast Network Holiday Extravaganza

Pain Science and Sensibility

The gang is all here (except Greg) for another festive dump of holiday cheer! Happy Holidays everyone!!!

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050 Pain Flare-Up show art 050 Pain Flare-Up

Pain Science and Sensibility

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! Søren T Skou, Dorte T Grønne, Ewa M Roos. J Orthop Sports Phys Ther. 2020 Jun;50(6):309-318. doi: 10.2519/jospt.2019.9125. Epub 2019 Sep 6. Music by Kevin MacLeod - : Intro - Brandenburg No4 and Meatball Parade Close - Meatball Parade

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049 Contemplating Possibilities and the Impermanence of Pain show art 049 Contemplating Possibilities and the Impermanence of Pain

Pain Science and Sensibility

We are joined in this episode by 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 think that we could/should explain pain? Does Sandy work pelvic health examples into this conversation? Music by Kevin MacLeod - : Intro - Brandenburg No4 and Meatball Parade Close - Meatball Parade

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048 The SI Joint Narrative show art 048 The SI Joint Narrative

Pain Science and Sensibility

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! Palsson TS, Gibson W, Darlow B, et al. Phys Ther. 2019;99(11):1511-1519. doi:10.1093/ptj/pzz108 Due to copyright laws, unless the article is we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, . Music by Kevin MacLeod - : Intro - Brandenburg No4 and Meatball Parade Close -...

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047 Is It Safe For Women To Lift Heavy Things? show art 047 Is It Safe For Women To Lift Heavy Things?

Pain Science and Sensibility

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 published cross sectional study that is a start to this research. There are some important implications of this and potentially some misconceptions that are driving current approaches. Please listen as we are joined by physiotherapist and PhD candidate,...

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046 Is There an Advantage to Pain Free Rehab? show art 046 Is There an Advantage to Pain Free Rehab?

Pain Science and Sensibility

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 the other is a systematic review and meta analysis of the approach in chronic pain populations. Hickey JT, Timmins RG, Maniar N, Rio E, Hickey PF, Pitcher CA, Williams MD, Opar DA. J Orthop Sports Phys Ther. 2020 Feb;50(2):91-103. doi:...

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045 A Review of Surgery for Rotator Cuff Tears show art 045 A Review of Surgery for Rotator Cuff Tears

Pain Science and Sensibility

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 Sensibility. Karjalainen TV, Jain NB, Heikkinen J, Johnston RV, Page CM, Buchbinder R. Cochrane Database Syst Rev. 2019 Dec 9;12:CD013502. doi: 10.1002/14651858.CD013502. Due to copyright laws, unless the article is we cannot legally post the...

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044 Cognitive Functional Therapy Vs. Group Therapy Plus Education show art 044 Cognitive Functional Therapy Vs. Group Therapy Plus Education

Pain Science and Sensibility

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. O'Keeffe M, O'Sullivan P, Purtill H, Bargary N, O'Sullivan K. Br J Sports Med. 2019 Oct 19. pii: bjsports-2019-100780. doi: 10.1136/bjsports-2019-100780. [Epub ahead of print] Due to copyright laws, unless the article is we cannot legally post the PDF on the...

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More Episodes

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 medicalization and why is so important? What predicts poor health outcomes related to regional pain disorders most robustly? What is the difference between a treatment act and a treatment encounter? Why do people shop in the placebo aisle of the grocery store? How is a well intentioned provider to proceed with care? All of this and much more in this episode.

Links to his books via Amazon:

         

Music by Kevin MacLeod - incompetech.com:
Intro - Brandenburg No4 and Meatball Parade
Close - Meatball Parade