Understanding Pain- Essential Education

painpain site 2There is no doubt that one of the greatest challenges for the clinician working in the field of musculoskeletal medicine is explaining to a patient the concept of chronic or persistent pain. I daily review investigations and findings which do not adequately explain many patients pain symptoms, only to be asked “if nothing’s broken, why do I have pain?” Even more difficult is the patient that is fixated on surgery as the answer for a painful condition where there is no evidence (beyond the presence of pain)for surgical intervention.
It is now well established that treatment approaches utilising a bio-psycho-social approach are far more successful, and do require an active education component on the nature of pain.

The Hunter Integrated Pain Service has produced a wonderful video resource explaining the nature of pain – well worth the time for the clinician and patient reviewing and planning management going forward. Equally useful is the ACI Pain Management Network education video.
For those who love written resources to assist patients and younger professionals, “Explain Pain” by NOI is in its 10th anniversary remains one of my all time favourites.

How fast does the Grim Reaper walk?

I would urge readers to read this rather brilliant analysis from the latest British Medical Journal (BMJ 2011;343:d7679) regarding the relationship between walking speed and mortality.

This article has implications for exercise prescription for preventative health in the older population; and as far as I am aware represents one of the first studies on it’s kind.
The study concludes that “the Grim Reaper’s preferred walking speed is 0.82 m/s (2 miles (about 3 km) per hour) under working conditions. As none of the men in the study with walking speeds of 1.36 m/s (3 miles (about 5 km) per hour) or greater had contact with Death, this seems to be the Grim Reaper’s most likely maximum speed; for those wishing to avoid their allotted fate, this would be the advised walking speed”.

Exercise is Medicine

What more can I say? Dr Mike Evans has created an excellent resource stressing the importance of exercise as a prescription in preventative medicine. View it, link to it, promote it.

Can you meet the challenge?

Exercise and Weight Loss? Fact or Fiction

Throughout my studies and professional life exercise has been constantly recommended as one of the essential components of any weight-loss program. But is exercise really essential to weight-loss?

If one considers the “formula” for weight loss closely (burn more calories than you consume), then doubtless exercise is important as a means of burning more calories, both during and after exercise (post exercise increase in metabolic rate). However the sheer volume of exercise required to burn off that burger (6km run) or chocolate bar (swim for an hour) means that to really shift weight you need to become extremely fit. Whilst undertaking this amount of exercise may indeed be very healthy for a number of other reasons ( heart and lung health, mental state, improving sleep, fun and leisure), it’s clear that exercise alone has a small influence on weight loss in healthy individuals. Indeed, building muscle via weight training (and hence increasing your body’s metabolic rate) may be a more efficient means of increasing energy output for many individuals.

Given current society’s “obesity epidemic” it is clear that exercise alone is only a very small part of the answer. Indeed the answer may well be found by examining not only how much we eat, but what we put in our mouths.

After decades of various agencies and groups promoting low fat diets it’s clear that the obesity problem continues to grow (no pun intended!). Perhaps it’s time to consider sugar and in particular fructose as a relative recent introduction into the human diet (in large quantities) as one of the greatest contributors to poor health and increasing waist lines!
I would encourage all readers to closely examine their diets and consider the amount of sugar they consume. Next time you’re at the shopping center read the labels and check how much sugar you consume. Look at the amount of sugar added to your favourite products. Even better, do your body a huge favour and read David Gillespie’s excellent book, Sweet Poison or read his blog. I guarantee that this will definitely change the way you look at your diet, and have a positive effect on weight-loss and health. Go on, I dare you!

Sugar and Spice….. Not Very Nice!

The link between sugar and diabetes, sugar and heart disease, sugar and prostate cancer…. Fact or Fiction?
I would urge readers to at least read the blog of a very passionate and informed gentleman, David Gillespie, who has critically reviewed the literature on the links between health and sugar consumption. Some effort considering David had to educate himself on the science involved!
It’s not often that I throw my support behind a cause- but David’s writings- and make no mistake, it is “his cause”, make valuable reading and really encourage one to question the reliability, validity and relevance of the Australian Heart Foundation’s Tick of approval. Do your health a favor and check David’s blog regularly.

Australian Bone Marrow Registry

Please consider one of the greatest gifts you can offer. As a Father I would do anything for my children, and in promoting this site I hope that I am able to help many other children. Indeed I do have a friend whose 17 year old son is currently searching for a matching donor, and I honestly (even as a health professional) was not aware of the process or existence of the registry. Please consider.
The following is an excerpt from the Australian Bone Marrow Registry Site

Many Australians each year are diagnosed with leukaemia or other fatal blood disorders. A bone marrow or haemopoietic stem cell transplant is the only possibility of cure for many of these patients.

Donors need to be specifically matched to the patient which can make it very difficult to find a donor for certain patients with rare tissue types. Only 1 in 1000 donors will be asked to donate for a patient requiring a transplant in any given year.

Siblings are the ideal donors for a patient in need of a bone marrow or haemopoietic stem cell transplant, but only one patient in three will find a matched donor within their family. The other two in three patients rely on the ABMDR or other international registries to find a suitable match. With your commitment to become a donor we can continue helping those patients in need.