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Loved facilitating the Reasoning panel at #TheBigRs but have to leave early for Oslo... #PainCloud awaits! https://t.co/EW1kwgKaI3
@pinpointedu Thanks for sharing, Tania! God kveld from Norway! #Paincloud2018
Beautiful, chilly sunset in #Oslo this evening. And the sky didn't get completely dark until 10:05pm! Eager for #Paincloud2018 in less than 7 hours. @paincloud1 https://t.co/L69O1bFuQv
@felicitythow here, ready for this stellar line up at #PainCloud in Oslo 🇳🇴 I’ll confirm the hashtag soon but expect live tweets all weekend (as if #TheBigRs and #PRS2018 content wasn’t enough free CPD for one week) https://t.co/mICLJk4ZTJ
Worth noting Oslo is an hour ahead of UK time! We’ll be using #paincloud if you’re following.
Rafa and I are ready! https://t.co/VbT5oqAd3W
| Saturday | to Top |
#PainCloud2018 It's starting. @SandyHiltonPT @OleMsal @paincloud1 @SarahHaagPT @massagestl https://t.co/rYoiNgFTMU
The cast members who contributed to #PainCloud2018. @adiemusfree @OleMsal @larsavemarie https://t.co/J9njkWjL2z
I’ll be live tweeting PainCloud conference 2018
https://t.co/ccA90SxinF! #paincloud https://t.co/ccA90SxinF
Good luck @MyCuppaJo presenting at the #paincloud2018 I know you will be awesome, promoting the Pain self-management message to the healthcare professionals attending the weekend ðŸ‘
First up @MaryOKeeffe007 - she’s published a lot of work lately answering practically relevant clinical questions - really helped my practice lately. #paincloud
@MaryOKeeffe007 talking now at #PainCloud. The hard thing will be to get her to stop @kjartanfersum @DerekGriffin86 @PeteOSullivanPT https://t.co/LNoXoabQOA
@adiemusfree are you attending #paincloud2018 Bronnie?
#PainCloud starts by presentation of @MaryOKeeffe007 ’Talking the talk but are we walking the walk’ https://t.co/EqXofK287h
Talking the talk but are we walking the walk? With the “princess†of PT in LBP research @MaryOKeeffe007 #paincloud https://t.co/ELlG8oWjcD
We know that unecessary imaging is harmful but just how useful are red flags? Are they evidence based? @MaryOKeeffe007 #PainCloud https://t.co/GikIPYhgeZ
Mary highlighting the difficulty of screening & monitoring for red flags whilst not over-medicalising/imaging patients #paincloud
Dr. @MaryOKeeffe007 is coming up, who is from the University of Sydney.
Do physios walk the talk? #PainCloud2018 https://t.co/HkEkBPBKkx
Is the "just in case" approach justified for LBP? Where did the red flags come from? Case studies? @MaryOKeeffe007 #PainCloud https://t.co/C1kFrW4fY5
80% of people will have a red flag when the come to see you. For cancer - only well founded red flags are history of malignancy and ‘strong clinical suspicion’ #paincloud
Red flags or red herrings?
Red flags aren't always that 'red'. Most of these "red flags," such as gender, age, posture, injury, aren't directly causal to #LBP, but they are risk factors. Don't scare your patients/clients. @MaryOKeeffe007 #PainCloud2018
Some do and some don’t #PainCloud2018 https://t.co/nFEbANKXTa
Dr. @MaryOKeeffe007 is coming up, who is from the University of Sydney.
Do physios walk the talk? #PainCloud2018 https://t.co/HkEkBPBKkx
What a fantastic effort to organize and set up this event #PainCloud attracting people from near and far â¤ï¸ðŸ™Œ
Founder @OleMsal welcoming us and introducing the PainCloud collaborators. Exciting times ahead! https://t.co/nymIcwdIZw
Limited evidence for red flag factors in back pain but clusters of items might improve accuracy #paincloud
When it comes to imaging & red flags, do our biases get in the way? @MaryOKeeffe007 #PainCloud https://t.co/69MsUE4JrP
"It's naive to think that a scan is reassuring [for low back pain." ~ @MaryOKeeffe007 #PainCloud2018
Our own biases exist because we are human - do we need to try to de-bias ourselves? #paincloud
How many patients that go on to develop chronic pain are really assured by their scan? #scanjustincase #paincloud @MaryOKeeffe007
We need a better term than “nonspecific†low back pain #paincloud
Does anybody actually believe the term non-specific low back pain? 🤔🤔🤔 #PainCloud2018 @MaryOKeeffe007
The “temporary term†non-specific. Is it time to change it? @MaryOKeeffe007 #paincloud https://t.co/EoayTtYiJs
Foolish to say that tissues are irrelevant @MaryOKeeffe007 #paincloud
No need for pendulums: clearly back pain isn’t all about tissues but clearly we can’t say tissues are irrelevant either @MaryOKeeffe007 #paincloud
Pursuing promising behavioral approaches doesn’t mean we ignore biological potentials for tissue treatment either #paincloud @MaryOKeeffe007
Clearly not all about spinal tissues, but foolish to say tissues are irrelevant. @MaryOKeeffe007 #PainCloud2018 #physiotherapy
Current research indicate that asymptomatic subjects have more "stuff" going on in their spine than symptomatic subjects. https://t.co/oynB9WGKAj
The search for the "cause" of LBP goes on but is it really helpful? @MaryOKeeffe007 #PainCloud https://t.co/k8iNoRUPkP
Should we be looking for a pain generator? And how does all this fit with the bigger pain paradigm? #paincloud @MaryOKeeffe007
Medical providers including PTs unprepared to treat people with pain and psychological factors that influence recovery - we judge them unfairly too! @MaryOKeeffe007 #paincloud
#CLBP clearly not all about spinal tissues, but foolish to say tissues are irrelevant. @MaryOKeeffe007 at #PainCloud https://t.co/jGxUmGhJt4
Generally, physios have a poor ability to identify psychosocial factors for LBP. Oftentimes, they stigmatize patients for their "complaining" and "demanding attention."
"I'm just a physio. WTF can I do for psychological issues?"
@MaryOKeeffe007 #PainCloud2018
Helping people get out of the “not my job / scope of practice†mindset when it comes to simple evidence based advice is probably important too @MaryOKeeffe007 #paincloud
SOP: Evidence has moved on. If we don't do this, someone else will. 😬😬😬
It may be too late to complain then.
It's a tough gig but that's because humans was extremely complex. #ManyManyLayers #PainCloud2018 @MaryOKeeffe007
“But I’m not a psychologistâ€
But we are good at working with humans and who doesn’t have a psychological/social issue in their life? #paincloud
We know what low value care is (opioids, advanced imaging, surgery, interventional) - but what is high value care? @MaryOKeeffe007 #paincloud
The ineffectiveness of a treatment does not by default make non-pharmacological/surgical treatments effective. @MaryOKeeffe007 #PainCloud https://t.co/1kWgaMcTZk
“We might predict that an ineffective but theatrical interactive therapy might be expected to return small but inconsistent short term effects...†#NonPharma @MaryOKeeffe007 #paincloud
Don’t be zealous about PT. What is high value care anyway? #paincloud @MaryOKeeffe007
Lots of problems with many nonpharmacological treatments - lack clear theroretical basis and based on uncontrolled observation and small effect sizes @MaryOKeeffe007 #paincloud
How can we ensure high value care? LBP research an area ripe for exaggerated effect sizes. Do we hold it to the same accountability as pharmacological research? #paincloud
Do we try to hang on to treatments by "shifting the goalposts" with a "new" explanation? @MaryOKeeffe007 #PainCloud https://t.co/s028SZHI8I
Is non-pharma treatments for #CLBP really better than the pharma treatments? We need to further develop high-value treatments! @MaryOKeeffe007 #PainCloud https://t.co/i5so8tRued
LBP research saturated w/ exaggerated effect:
* Mostly small studies
* risks of internal study biases, yet effect sizes are still small & inconsistent.
More likely, effects are influenced by theatrical rituals of manual therapy than treatments. @MaryOKeeffe007 #PainCloud2018 https://t.co/Bs7dyhKTqN
Will taking pts away from meds and replacing with non-pharma care make people’s understanding of their pain any better? Especially if WE don’t understand our treatment effects #paincloud
@MaryOKeeffe007 doing a great jobs summarizing key issues in The Lancet LBP series to the audience https://t.co/VcK4BTlJLG #paincloud
Don’t put fear and preoccupation in physical activity @MaryOKeeffe007 #paincloud https://t.co/Kcc23dXYGp
Do we promote exercise but with a biomechanical bias? @MaryOKeeffe007 #PainCloud https://t.co/nyd4tJdk8c
Mary says let’s avoid giving red lights and make sure we give green lights when recommending physical activity to build confidence #paincloud
“Unlocking the potential of physical activity for back health†- https://t.co/94ZQxTwPhz @MaryOKeeffe007 #paincloud
Don’t give mixed messages during a session like «exercise is really good for you, but you also need these insoles...» 🙄 #PainCloud https://t.co/2KCd4mkRLe
We must open up physical activity "to be bigger than the physical". @MaryOKeeffe007 #PainCloud
Making physical activity more than physical @MaryOKeeffe007 #paincloud
“Do we argue about the wrong things†in back pain care - fits my bias for sure of the low value of many social media debates on tiny issues @MaryOKeeffe007 #paincloud
Exercise rarely targets the physical stuff we think it does (Steiger et al, 2011). Can we get better at opening our physical activity advice up beyond the biological? #paincloud
We tend to focus on the "bio" when prescribing exercise for LBP. Exercise rarely changes the physical components we target (Steiger et al 2011).
Some misconceptions of movement and exercise are indicated in the illustration below. #physiotherapy
@MaryOKeeffe007 #PainCloud2018 https://t.co/Eh441f4NM9
There are still many basic misconceptions about LBP among the general public. We argue over the finer details but we must change societal beliefs first. @MaryOKeeffe007 #PainCloud
Are we missing the main goal while discussing «important» details?
We NEED a change of fundamental misconseptions on a societal level!
#PainCloud @MaryOKeeffe007 https://t.co/IXMutsLAG9
Excellent presentation from Dr Mary O’Keefe at Paincloud 2018! How we might “walk the talkâ€! Becoming more comfortable and confident in uncertainty and being aware of our own cognitive biases through patient narratives. @MaryOKeeffe007 #PainCloud https://t.co/yhkYanoVB6
What can we do now based on current knowledge? Be aware of our biases - practice deliberate debiasing, embrace complexity, listen to obvious but uncomfortable perspectives @MaryOKeeffe007 #paincloud
Countering cognitive biases in minimizing low value care https://t.co/of6RyCrRAL #paincloud @MaryOKeeffe007
Abandon any theories proven to be unhelpful or simply incorrect, whether it's "hands-on" or "hands-off." Mary O'Keeffe #PainCloud2018 https://t.co/FKTteVWmXW
begin to train to feel confident with uncertainty in managing pain @MaryOKeeffe007 #PainCloud
Abandon the theories proven to be wrong or unhelpful - labels, theories, processes @MaryOKeeffe007 #paincloud
Practical advice from Mary on how to walk the talk:
Get comfortable with uncertainty and risk, read patient narratives, reflect on our own biases, read this paper, listen to build trust, not necessarily a diagnosis, abandon unhelpful theories rather than Rx #paincloud https://t.co/D0cLqwAr2L
Importance of NARRATIVE and CONTEXT @GiacomoRoss86 @MaryOKeeffe007 #paincloud https://t.co/Uu1qujVsyZ
@SigMik What is the official hashtag for the PainCloud conference? #paincloud or #paincloud2018
Balance listening and first person narrative without aiming strictly for satisfaction - what do patients tend to care about? https://t.co/INsStg62mW @MaryOKeeffe007 #paincloud
“But my patient expects Treatment xâ€
Patient satisfaction not correlated with patient outcomes, don’t confuse the two! #paincloud
Classification or categorization approaches have limited value in managing pain @MaryOKeeffe007 #paincloud
@paintoolkit2 @SigMik #PainCloud
Boxing of factors has no place in the pain experience #paincloud @MaryOKeeffe007
Don’t just explain pain, explain the person’s pain @MaryOKeeffe007 #PainCloud
Avoid language that provokes a protective response in patients/clients in pain. Such as.....?
@MaryOKeeffe007 #PainCloud2018
Redefine recovery as not permanent absence of symptoms but long term management and self care @MaryOKeeffe007 #paincloud
Our job is not to explain pain - it’s to explain an individual’s pain and for that we need to listen to all of the jigsaw pieces #paincloud
Arm people with strategies to self manage future episodes - help them adapt @MaryOKeeffe007 #paincloud
Avoid the trap of moral superiority in health advice - find what works and is supportable for each individual person @MaryOKeeffe007 #paincloud
Tackle long term misconceptions in government policies/advice, media, clinical training programs about pain and function @MaryOKeeffe007 #paincloud
Maybe we should give up on prevention and redefine recovery. Allow people to have a ‘flare up’ and use their own strategies to get through it #paincloud https://t.co/v04eBpmUum
Who defines positive health? Encourage people to get back to MEANINGFUL activities, which might be working 60 hour weeks or baking cakes rather than our own ideas of healthy living #paincloud
People use mask and camouflage to hide themselves, the difference is between them is partial and complete. I use mask to hide my #paincloud from others and waiting for the camouflage to cover up me completely...
#thoughts
Now getting to hear @larsavemarie on detoxifying your clinical reasoning process #paincloud
Nope and using the term ‘setback’ is better than flare up #PainCloud Don’t take my word for it, ask your patients https://t.co/3cwf3Nw23p
Maybe we should give up on prevention and redefine recovery. Allow people to have a ‘flare up’ and use their own strategies to get through it #paincloud https://t.co/v04eBpmUum
Knight of Righteousness in Health Care @larsavemarie as labelled by our MC #paincloud
Always best if we have setback plan #paincloud https://t.co/qiIDtkPQQb
Arm people with strategies to self manage future episodes - help them adapt @MaryOKeeffe007 #paincloud
Next up, Lars Avemarie on how to detoxify our clinical reasoning process #paincloud
@larsavemarie: “Physiotherapy is amazing but could be done more amazingly†#paincloud
Keeping active is quite popular with us #paincloud https://t.co/o0LjtAmbVb
We must open up physical activity "to be bigger than the physical". @MaryOKeeffe007 #PainCloud
Detoxifying your clinical reasoning - very excited to hear from Lara Avemarie! @larsavemarie #PainCloud https://t.co/w0NiiZmzUs
@larsavemarie “Physiotherapy, osteopathy, chiropractic, occupational therapy, pain management are amazing - but could be better†Helping people think better and avoid reasoning errors #paincloud
I’m definitely at the right conference!
Talk by @larsavemarie
“Physiotherapy....is amazing but could be more amazingâ€
#paincloud https://t.co/sE9GNT9cDc
Cognitive biases are not random! They are systematic deviations of reasoning. @larsavemarie #PainCloud
Keeping it simple comes to mind #paincloud https://t.co/WakUFz4yuF
@larsavemarie: “Physiotherapy is amazing but could be done more amazingly†#paincloud
“I consider myself a student of science - I hate when people call me an expert†@larsavemarie #paincloud
Biases are wired into us...â€if our brains were computers, no one would buy it†Be aware of your bugs! #paincloud
Great photos and visuals for speaking on cognitive biases by @larsavemarie #paincloud
Critical thinking can ‘detoxify’ erroneous ideas #paincloud
Important to understand we all should work together for betterment of patients #paincloud2018 https://t.co/EH742A8qjh
The open minded response is often used when you don’t agree with the specific argument someone is making - no one says this whenyou agree with them @larsavemarie #paincloud
The "open mind" argument is usually only brought up when you disagree with someone. It's flawed! @larsavemarie #PainCloud
Don’t be open minded - don’t be open to anything, but you should only let in quality ideas @larsavemarie #paincloud
Research doesn’t care what you think - it’s very humbling @larsavemarie #paincloud
Lars: having an open mind less useful than having a mind like the eye of a needle. Let ideas in but use science as a guide to filter them #paincloud
“Research is very humbling in changing beliefsâ€
@larsavemarie #paincloud https://t.co/xD8UytbiFe
Are there still too many "fantasy explanations" for what we do? @larsavemarie #PainCloud https://t.co/5hZQILuD7N
Research doesn't care what you believe. It is quite a humbling experience. #PainCloud2018 @larsavemarie https://t.co/3BOZd1iF81
“So I can’t talk about critical thinking or profanity and not talk about @AdamMeakins†- @larsavemarie #paincloud
Talking the talk but are we walking the walk? Great start! #paincloud @MaryOKeeffe007 https://t.co/YThsUECOkG
The foundation for good clinical reasoning is critical thinking @larsavemarie #paincloud
@ellymthomas They do Elly #paincloud #auspain19
https://t.co/sggJ5gZV5F Avoidance of Logical Fallacies: a neglected aspect of scienceâ€education and scienceâ€teacher education @larsavemarie #paincloud
“Perfect Reasoning is as rare as perfect healthâ€
We are not all logically reasoning individuals! #paincloud
The basis for your clinical reasoning should be sound critical thinking! @larsavemarie #paincloud https://t.co/sEtn8mexsj
The first rule of Critical Thinking 🤔 club 🙌🙌🙌 #paincloud @larsavemarie https://t.co/ZUkHQH9sxk
Yes, many still using #oldskool ways/thinking and pain selfmgt has really moved on #paincloud https://t.co/YTsz05ZkIZ
This one made me 🤔
@Cerys_Preston #paincloud @larsavemarie https://t.co/EgCVEHPDPW
“The normal response to a flawed argument is ten more flawed arguments†#paincloud
“You should not assume that people are using a reasoned argumentâ€
@larsavemarie #paincloud https://t.co/ySbjJsRjF2
Critical thinking is a skill. It’s not something you can memorize or just look up. @larsavemarie #paincloud
Clinical reasoning is a skill that takes practice! #paincloud
@majasigz @MaryOKeeffe007 How can patients walk the walk when many healthcare professionals don’t. We look to you guys to be our coaches #paincloud
System 1 vs System 2 thinking process review - valuable! @larsavemarie #paincloud
System 1 thinking is fast & intuitive, almost effortless.
System 2 thinking is slower & demands more processing.
Each system has its pros & cons. It's a matter of when and how you use each system. #PainCloud2018 @larsavemarie
https://t.co/87WMYrcq86
Diagnostic error often linked to over-reliance on System 1 (intuitive) thinking over the more deliberate cognitive approach of System 2 #paincloud
“The scary part is the bottom part: when you don’t know what you don’t knowâ€
@larsavemarie #paincloud https://t.co/ZFYdVmePll
Better to be consciously incompetent than unconsciously incompetent #paincloud https://t.co/1NsNHYApgP
It’s very accurate Helen #paincloud https://t.co/lVdFcJAk9s
“The scary part is the bottom part: when you don’t know what you don’t knowâ€
@larsavemarie #paincloud https://t.co/ZFYdVmePll
Thinking about thinking whilst we’re thinking to make our thinking better #PainCloud #Criticalthinking
Make sure to practice internal as well as external critical thinking - first and foremost it starts with you - your own beliefs should be questioned first @larsavemarie #paincloud
It’s been great following the #PainCloud tweets, but I need to have a ride out on the bike. Catch up with the tweets later #paincloud https://t.co/2rU7p4tKoq
Thanks @larsavemarie for mentioning me in your talk - I’m honored to have been helpful! #paincloud
@larsavemarie “make conclusions independent of your own or other peoples’ beliefs†Let’s get proven wrong and be ok with it/learn from it #paincloud https://t.co/rfyEzilfmg
Second rule of the Critical Thinking 💠club 🙌🙌 #paincloud @larsavemarie https://t.co/tDJztq2RV3
Great updates from #paincloud today. Keeping an eye while Mrs @rehabrich chauffeurs us to that there Laaandan
“Critical thinking is a way of realizing you were mistakenâ€
“Frame it positivelyâ€
#paincloud @larsavemarie https://t.co/jqDOieiKfU
Beware of bias bias! That everyone is biased but you...ok Twitter? 😜 #paincloud
Specify whether you are making a subjective opinion claim or an objective truth claim when communicating @larsavemarie #paincloud
If you're human, this holds true. Don't convince yourself otherwise. @larsavemarie #PainCloud https://t.co/G4F1THQy5k
Overconfidence bias: Believing you know more than someone else, acting on incomplete info or hunches, & prioritizing opinion or authority, as opposed to evidence. #PainCloud2018
Bandwagon effect: "We all do it this way." "We have used it for many years by many clinicians." #PainCloud2018
Sutton's slip: Going for the obvious diagnosis. Follow the $$$$. #paincloud2018
Search satisfying: Having found 1 diagnosis, other co-existing conditions are not detected. #PainCloud2018
Outcome bias: Over-emphasizing or minimizing the signif of a finding or result. #paincloud2018
Five cognitive biases to avoid: Overconfidence, Bandwagon Effect, Sutton’s Slip, Search Satisfying, and Outcome Bias @larsavemarie #paincloud
🤠#paincloud
“Don’t make modalities our teddy bearâ€ðŸ» @larsavemarie https://t.co/8py7CrKo4k
Thinking errors: Bias Blind Spot (others are biased, not me), Emotional Attachment to an idea (teddy bear effect) @larsavemarie #paincloud
“We should not make our modalities our teddy bearâ€
#paincloud @larsavemarie https://t.co/oTlSlmR4ZG
Do not make your modality your "teddy bear." Emotional attachment to your modality can be painful if your "teddy bear" turns out to be wrong. @larsavemarie #PainCloud2018
Thinking errors: @larsavemarie quoting @CoachNickT on practical application of critical thinking now “2+2=5†example #paincloud
Anyone got a treatment teddy bear? Or perceptions you couldn’t bear to be knocked around or lose? #paincloud https://t.co/ZMFNuGZu5P
“Essential reading for all physiotherapy studentsâ€
BTW: I stood consider myself a student: note to self. Read this paper!
#criticalthinking #paincloud @larsavemarie https://t.co/Q542fCZuXC
Changing people’s minds is hard - focus on changing your own thinking process first @larsavemarie #paincloud
@larsavemarie reminds us of this quote. "It modulates the nervous system" or "novel input" or "window of opportunity" come to mind! #paincloud https://t.co/13JUaitTNx
“Recommended reading on critical thinkingâ€
#paincloud @larsavemarie
The first one is free as ebook! https://t.co/5RAKgwpswf
Be mindful of your own world views and biases when arguing your point.
Maybe people get better not because of what we do but in spite of it...
#paincloud https://t.co/wBTRznBN7o
@LucaCossarini @larsavemarie You're rocking the tweets at #PainCloud - go Luca!
Q and A with @MaryOKeeffe007 #paincloud
“How do we influence the influencers in social mass education programmes?â€
Paper out soon.....
More questions than answers....
@MaryOKeeffe007 Q&A One of the hardest parts of working with journalists is that they put so much contradictory information out there without realizing it #paincloud https://t.co/spXK9MLb5h
People aren’t getting consistent accurate information about back pain @MaryOKeeffe007 #paincloud
Journalists tend to publish contradictory stories. EX: one journalist would write a more accurate story on LBP from credible expert (e.g. PT, researcher), yet another from same news source write same topic w/ less credible "expert" (e.g. celebrity) @MaryOKeeffe007 #PainCloud2018
CONF., ongoing: Pain Cloud Convention –––– 2018 Oslo, Norway April 21-22 TWO heavily used hashtags: #PainCloud & #paincloud2018
Website: https://t.co/FZYbUryiuv
Schedule https://t.co/ud9UCtSRGb
Thread: Twitter vignettes from the event:
Related:#pain #chronicpain #PT #physio https://t.co/iQaQKbxXgi
Seems that @MaryOKeeffe007 did a great talk at #paincloud with important messages ! #wishIwerehere #MSQ2002 https://t.co/O48OCqIdjr
The ineffectiveness of a treatment does not by default make non-pharmacological/surgical treatments effective. @MaryOKeeffe007 #PainCloud https://t.co/1kWgaMcTZk
Continued Thread: CONF.,Pain Cloud Convention –––– 2018 Oslo, Norway April 21-22 Hashtags: #PainCloud & #paincloud2018
The schedule -at a glance.
Related tags: #pain #acutepain #chronicpain #physio #PT
A smart #physiotherapy event~ https://t.co/H1oNhz0oPu
Now @Tash_Stanton on the multi sensory patient: novel findings from neuroscience and their clinical implications #paincloud
Everything we experience is influenced by many things we don’t realize @Tash_Stanton #paincloud
@Tash_Stanton : Reliable senses like vision can be tricked in optical illusions, no wonder our pain perception can be influenced by factors we’re not even aware of #paincloud
Cues of danger/safety influence the pain experience. Based on prior learning. @Tash_Stanton #PainCloud https://t.co/6o59zL7Qjh
Behavior can be influenced by social cues.
In this example, the type of stares someone gives you when you shop could influence how much you're willing to pay for something.
Could this be extrapolate to pain perception?
https://t.co/xKd4Or23w4
@Tash_Stanton #PainCloud2018 https://t.co/bDEKja1IR9
Everything we do involves a priming effect, often without us even knowing #paincloud https://t.co/2nV2OGEpdK
@Tash_Stanton providing some great insights from current neuroscience on perception of our bodies & environment and its influence on pain #paincloud https://t.co/lpYCTg7Nx1
Your perception of your body influences how you see the world around you. @Tash_Stanton #paincloud
Cont. Thread: CONF., DAY 1: Pain Cloud–– 2018 Oslo April 21-22
#PainCloud {#paincloud2018}
First Speaker: @MaryOKeeffe007 ––"Talking the talk, but are we walking the walk?"
Reference: The Lancet Series: Low Back Pain
https://t.co/vsKplxSR4F
Tags: #backpain #pain #chronicpain https://t.co/Qj3SI5l5Ea
@jasonsilvernail @MaryOKeeffe007 What information do you think we should get? #PainCloud
@Tash_Stanton casually blowing our minds with neuroscience. Body perception can be altered, can we alter these perceptions to affect pain? #paincloud https://t.co/CQrQsNZYnv
Visual feedback of the back with movement can have an analgesic effect. Can we use this in clinic? #paincloud
Cont. CONF., DAY 1: Pain Cloud–– 2018 Oslo April 21-22
#PainCloud {#paincloud2018}
Speaker: @MaryOKeeffe007 Imaging for low back pain is NOT indicated ––except?
The 'red flag' issue re: imaging in #LBP: evidence based?? #EVB
Sampling of 'red flags' @ the world
Ty 2 tweeters! https://t.co/5oH1SwKlqA
@ellymthomas We are all learning Elly 👨â€ðŸŽ“👩â€ðŸŽ“
Did you know I’m starting online Pain Toolkit workshops next month for healthcare professionals https://t.co/m5DtAvyTSt #PainCloud
Cont. CONF., DAY 1: Pain Cloud–– 2018 Oslo April 21-22
#PainCloud {#paincloud2018}
Speaker: @MaryOKeeffe007 Research: Asymptomatic subjects have more "stuff" going on in their spine than symptomatic subjects. Spinal tissue plays a role, but less than we might think. #pain #LBP https://t.co/TRE3ncPwGS
Research shows we can alter pain experience by altering perceived body size. Can it change emotions or perception of environment? Maybe but not known yet #paincloud
Applying force to a spine with a creaky sound increases perception of force and stiffness. Whoosh sound did the opposite! #paincloud
Sound can influence how stiff you perceive your back stiffness. #PainCloud2018 @Tash_Stanton https://t.co/3pBXvQkDsK
Cont. CONF., DAY 1: Pain Cloud–– 2018 Oslo April 21-22
#PainCloud {#paincloud2018}
Speaker: @MaryOKeeffe007 RE: #lowbackpain & imaging:
MT @DerekGriffin86
Most "red flags" lack diagnostic accuracy.
When it comes to #imaging & red flags, do our biases get in the way?
#pain #LBP https://t.co/dvJVYosOSO
Bodily state influences your perception: fatigue and pain increase your perception of difficulty and some negative aspects of the environment @Tash_Stanton #paincloud
Our bodily state heavily influences how we perceive our environment. Extremely relevant for chronic pain and fatigue states! @Tash_Stanton #PainCloud https://t.co/fLGneHNzde
Fear makes you think that a slope is steeper than it really is! @Tash_Stanton #paincloud https://t.co/gurrrXPt5x
Fear increases our perception of hill steepness (Stefanucci et al, 2008), does fear influence our patient’s perception of the difficulty of tasks? #paincloud
Cont. CONF.,DAY 1: Pain Cloud–– 2018 Oslo April 21-22
#PainCloud {#paincloud2018}
Speaker: @MaryOKeeffe007
MT @TPMPodcast
80% of ppl will have a red flag when they come to see u. RE: cancer, the only well founded 'red flags' r history of malignancy & ‘strong clinical suspicion’ https://t.co/VqBdZQZEvx
Tasha Stanton from Body In Mind group, how multisensory inputs from bodily, evironmental and emotionel perceptions influences pain #paincloud https://t.co/ilh91K3knz
When you smell something horrible (e.g. fart), your pain sensitivity increases compared to a pleasant smell or neutral smell.
Thus, environmental cues can influence how we perceive pain. Does your clinic or spa smell like dirty feet?
@Tash_Stanton #PainCloud2018 https://t.co/HizQ3ACCNV
“Context is key! Think about where we get our patients exercisingâ€
#paincloud @Tash_Stanton https://t.co/ZWjHLAMCDO
High threat influences pain and anxiety #paincloud @Tash_Stanton
“Stimuli are more likely to be perceived as painful and they can hurt more when they are perceived to be harmfulâ€
@Tash_Stanton #paincloud https://t.co/wedQtue8PY
Pain can be influenced by unpleasant smells! Multi sensory inputs are key considerations in pain experience, Can we help to adapt our patients’ environment in clinic or at home where they ‘do stuff’ to reduce pain? #paincloud
Implicit bias is more predictive of behaviour. @Tash_Stanton #paincloud
@Tash_Stanton highlighting @jpcaneiro work on implicit learning in pain. https://t.co/gqaZqjzQsW #paincloud https://t.co/JhGQ2kTbZS
Our patients have implicit biases too - it’s up to us to discuss them and try to show how they can be impacting pain #paincloud
Brilliant talk by @Tash_Stanton Very exciting times for chronic pain! Great things will emerge from Tasha’s work 🙂 Fascinating insights 🙌🙌🙌 #paincloud https://t.co/n43OF6bsrh
Novel findings from neuroscience and their clinical implications! Exciting stuff! Amazing work by @Tash_Stanton and Body in Mind research group #paincloud https://t.co/KuVzejcZ23
@MyCuppaJo points out the patient perspective is often missing in Physio/pain conferences #paincloud
“The patient perspective. So often missing from professional conferencesâ€
@MyCuppaJo
👌
Really looking forward to hearing this
#paincloud https://t.co/BD022w5Ul8
Joletta: “Be a compassionate presence to your patients. Sometimes it’s the only thing you can be†#paincloud
@MyCuppaJo presenting about a patient’s perspective. Amazing, brave, and insightful. Also a shout out to @lee_eugenie in the talk! #PainCloud https://t.co/T7pfo3vG09
Clinicians often forget patients' perspective. Too much is focused on the therapists' modality & narratives (ego), & don't listen to their them.
Patients like @MyCuppaJo are likely to make dents in progressing manual therapy & other healthcare professions. #PainCloud2018 https://t.co/ROptH7C8fj
"Sometimes compassionate attention is the best gift you can give to your patients/clients." ~ @MyCuppaJo (paraphrased) #PainCloud2018
No need to give (unsolicited) advice. https://t.co/uX10cQNyuo
@Tash_Stanton @MaryOKeeffe007 Hope ole is looking after you girls!! #paincloud #WomeninScience
Important to recognise social factors and speaking about shame and related topics #paincloud @MyCuppaJo
Joletta: “when you fail Physio and acupuncture and surgery, you start to think you are the one at fault - because your body should be fixed†#paincloud
Powerful insights from @MyCuppaJo on her experience of living with pain. Pain can make you feel "frail and broken". #paincloud
Pain can steal your identity. @MyCuppaJo speaking on her experience of loss #paincloud
Joletta: “losing my career meant losing my self worth, my sense of self†#paincloud
@TPMPodcast Better for what? Only one of those creates anxiety/distress.I am much more comfortable with one than the other. #PainCloud
@MyCuppaJo The Patient Perspective: lost identity and loss of valued personal activities #paincloud https://t.co/qOABjOhBlP
Joletta: “I was no longer the same person and I didn’t like the new pained me. No one addresses the things we’ve lost, the grief†#paincloud
Secondary gains. What about primary losses?? (!) #paincloud @MyCuppaJo
*Powerful* personal testimony from @MyCuppaJo on personal experience of pain and loss from chronic pain #paincloud https://t.co/53G8407rQq
"Your 2 o'clock hip is here". The dehumanisation of people with pain. @MyCuppaJo #paincloud https://t.co/XERbuXlc6G
Cont. CONF.,DAY 1: Pain Cloud–– 2018 Oslo April 21-22
#PainCloud {#paincloud2018}
Speaker: @MaryOKeeffe007
Not "just a physio' ––psychological key too
MT @jasonsilvernail
Pursuing promising behavioral approaches doesn’t mean we ignore biological potentials for tissue RX either https://t.co/GyotepQL4v
The pain charts and scales don’t address the suffering and loss @MyCuppaJo #paincloud
“Your two oclock hip is here†- dehumanizing patients in health ‘care’ @MyCuppaJo #paincloud https://t.co/RbBqQmKqnI
Cont. CONF.,DAY 1: Pain Cloud–– 2018 Oslo 4/ 21-22
#PainCloud {#paincloud2018}
Nice schema of a behavioral/ psychological/ emotional (=human ) cycle in #chronicpain. Humans are a complex package and we present for treatment with that complexity. #pain
REF:https://t.co/ao1aGzr4Yu https://t.co/6E6ECMBp2J
Cont. CONF., DAY 1: Pain Cloud–– 2018 Oslo, Norway April 21-22
#PainCloud {#paincloud2018}
Speaker: @MaryOKeeffe007
In the interest of not manufacturing fear, helpful to recognize BUT also 'normalize' psychosocial factors. #DoNoHarm #lowbackpain shared by many
H/T @DerekGriffin86 https://t.co/6tdEQjlP9e
We can lose who we are when we’re in pain. We seek new labels, and get given new labels #paincloud @MyCuppaJo
Pain stories can start before the pain starts. #wholeperson #paincloud @MyCuppaJo
“For me, my recovery started when I got out of the healthcare system†@MyCuppaJo - Lessons for how we can do better #paincloud
Joletta: “Bring compassion to the table because we don’t know why a patient is ‘difficult’†#paincloud
Words can change our worlds. Positively and negatively @MyCuppaJo #paincloud
“When I found Lorimer Moseley’s work or changed my life†@MyCuppaJo #paincloud Join the club, sister!
Joletta: “Humans are nuanced and complex. Being listened to makes you feel valued and your patient may not have experienced that in a long time†#paincloud
Get at the suffering part of pain - ask questions that get at what people have lost, what they no longer do and might not even imagine they could do again @MyCuppaJo #paincloud
You can still do the clinical assessment scales and stuff but you have to get to know someone to be able to help them @MyCuppaJo #paincloud
“One of my biggest pet peeves is separating out the bio from the psychosocial - we are also our biology†@MyCuppaJo #paincloud
Joletta: “Psychosocial is biology too - this mattered to me because it made me appreciate self care more: I could affect my physiology†#paincloud
@jasonsilvernail @MyCuppaJo A lot of us in that club - probably stopped me changing my career #paincloud
The most powerful presentation on pain I have ever heard in my life @MyCuppaJo 💪(and believe me, I have heard a lot!)
Honest. Brave. Vulnerable. Courageous.
Thank you 🙠for leading the way.
Hearing the patient perspective at conferences has to be the new thing!
#paincloud https://t.co/86SSuUuhhe
Commentary with @SigMik and @kjartanfersum next - Kjartan mentions the disconnect between how pain patients are treated (often not well) versus how other patients with chronic conditions are treated #paincloud https://t.co/nr26PB6nnB
@MyCuppaJo Wonderful talk, thank you for your open and honest account of your story so far. Vulnerability and courage in bucketloads #paincloud
Cont. CONF., DAY 1: Pain Cloud––2018 Oslo, Norway April 21-22
#PainCloud {#paincloud2018}
Speaker: @MaryOKeeffe007
MT @MassageFitMag We tend to focus on the "bio" when prescribing exercise for LBP. Exercise rarely changes the physical components we target (Steiger et al 2011) #PT https://t.co/OqbjKz6TyN
Discussion session with @kjartanfersum and @SigMik over beers...very interesting but they forgot their beers! #PainCloud https://t.co/LWBOSlBNUg
@SigMik: The map 🗺 - the BPS model
The terrain â›°- the lived experience
The guidebook 📖 - something like CFT? #paincloud
The map, the territory and maybe a guidebook? @kjartanfersum @SigMik #paincloud https://t.co/CORcsIroZ9
Pain Management: Roadmap To Revolution
Steven Z. George on PTJ
@kjartanfersum
@SigMik
#paincloud
https://t.co/GCOjLcNfwt
Kjartan thinks there has been a shift in understanding in Physio but important to keep evolving. He asks does your practice look different now to what it did 5 years ago? #paincloud
Sigurd: treating patients is more like managing a football team than a broken down car. Multifactorial! #paincloud
Mentioned by @sigmik at #PainCloud 2018 https://t.co/9LCckLeROg
Loving the cafe style discussion with @SigMik and @kjartanfersum
Philosophising on how to navigate the pain journey as a clinician
ðŸ‘ðŸ‘for the innovative format seen today @paincloud1 #paincloud https://t.co/8EqiiiA1jr
Sigurd: CFT starts with the patient’s understanding of the pain rather than our own #paincloud
@kjartanfersum @SigMik commentary on MI and the tension inside the clinician too #paincloud https://t.co/3zAGc2QsDF
Khartan: Talking about the pain experience is challenging because you’re having a conversation with them whilst having a conversation in your head...but don’t forget that Michael Jordan missed 9000 shots #paincloud
Both agree there can be friction between the patient and therapist when beliefs collide. “Try to make it a dance not a fightâ€
Meeting it with â›”ï¸ can create more friction #paincloud
Sigurd: start your therapeutic alliance with being polite and interested and professional because this builds the foundation we fight or dance on #paincloud
Dance or fight? Making sense of pain, patient narratives, understanding CFT with @kjartanfersum and @SigMik #paincloud https://t.co/QpWDxYU39m
Kjartan: “I’d love a conference where we discuss our failures†#paincloud
“I would love to have conferences that discuss our failuresâ€@kjartanfersum
“Do we, as clinicians, take time out to reflect on our failures?â€
“What constitutes failure?â€@SigMik #paincloud https://t.co/4YTgQbvZV3
Sigurd: you’d have to have a good rapport with someone before you tell them you disagree with their relationship choices. Likewise, we need to make sure we have a solid therapeutic alliance before we can expect to alter patients’ pain beliefs too #paincloud
“Sometimes patients have told me the only way they would admit to vulnerable emotive experiences is face down on the plinthâ€
Brilliant reflection from @kjartanfersum #paincloud
Thankful to all the tweeters @paincloud1 it looks lovely! Wishing I was there while happy to be right here following #PainCloud
Cont. CONF., DAY 1: Pain Cloud––2018 Oslo, April 21-22
#PainCloud {#paincloud2018}
Speaker: @MaryOKeeffe007 #LBP
MT @jasonsilvernail We know what low value care is (opioids, advanced imaging, surgery, interventional) - but what is high value care? (Not necessarily knee jerk PT) https://t.co/AdeXZJjpEj
That’s all for today @paincloud1 here in Oslo - hope you enjoyed, catch you all tomorrow! #paincloud https://t.co/xywNz4qdEB
Cont. CONF., DAY 1: Pain Cloud––2018 Oslo, 4/21-22
#PainCloud {#paincloud2018}
More: @MaryOKeeffe007
MT @MassageFitMag
LBP research saturated w/exaggerated effect:
* Lgly small studies
* risks of internal study biases, yet effect sizes r still small & inconsistent.
Role of ritual https://t.co/vhgkLsKUOv
Cont. CONF., DAY 1: Pain Cloud––2018 Oslo, 4/21-22
#PainCloud {#paincloud2018}
More: @MaryOKeeffe007
The 'moving the goalpost mentality' when explanations (or outcomes) come up short. (Pervasive in medical/ healthcare, something to be aware of & avoid.)
Here: RE: manual RX. #PT https://t.co/BMqepxDRt9
Cont. CONF., DAY 1: Pain Cloud––2018 Oslo, 4/21-22
#PainCloud {#paincloud2018}
More: @MaryOKeeffe007
Unlocking the potential of physical activity for back health ––
#LBP #PhysicalActivity #exercise #pain #lowbackpain
Not being realized because: 1,2,3,4,
1. The 'right' exercise.. https://t.co/mxPm508hFV
@Physio_Art @MyCuppaJo @Prestons_Health @BreneBrown @nayyirahwaheed #paincloud https://t.co/AROPBmG1H8
@Physio_Art @MyCuppaJo @Prestons_Health @BreneBrown @nayyirahwaheed #paincloud https://t.co/NtqvtiewpQ
Cont. CONF., DAY 1: Pain Cloud––2018 Oslo, 4/21-22
#PainCloud {#paincloud2018}
More: @MaryOKeeffe007
Unlocking the potential of physical activity for back health ––
2. Dilution of PA with adjuncts
3. Too much focus on 'bio', target 'part'
4? Focus on pos+, embrace uncertainty https://t.co/G7QhLQCRDc
Cont. CONF., DAY 1: Pain Cloud––2018 Oslo, 4/21-22
#PainCloud {#paincloud2018}
Continued Speaker: @MaryOKeeffe007
The way forward for effective RX for #lowbackpain
♦ï¸Be a good listener, be trustworthy
♦ï¸Glean context
♦ï¸Understand pt's needs/desires/goals & respond to those https://t.co/oGshE8pRx9
Cont. CONF., DAY 1: Pain Cloud––2018 Oslo, 4/21-22
#PainCloud {#paincloud2018}
Speaker: @MaryOKeeffe007
Way forward for effective RX ,#lowbackpain
♦ï¸Avoid neg- language, stoking 'fear', 'protection' /rigidity/avoidance
♦ï¸Check out these twitter vignettes on optimizing RX 🔽 https://t.co/I61ArlvshL
So true @MyCuppaJo Many of lose our identity because of the medical model most healthcare professionals use #PainCloud https://t.co/auVx7mJFqx
We can lose who we are when we’re in pain. We seek new labels, and get given new labels #paincloud @MyCuppaJo
Check out the recent interviewing I did with @MyCuppaJo #PainCloud https://t.co/pZCqN7ayQR
#PainToolkit
“People drawn to CFT are:
1) cognitively flexible
2) don’t have a big ego
3) and really care about peopleâ€
Personal opinion of @Physio_Art in the pub @paincloud1 #paincloud
@Tash_Stanton @MaryOKeeffe007 @GregLehman @SandyHiltonPT Seemed pretty important for this person #paincloud https://t.co/C6FWCcXaxs
@felicitythow here, back @paincloud1, keep an eye on #paincloud for live tweets from the event. If it’s anything like yesterday, you won’t want to miss this! https://t.co/8qTGsNbI7V
Is this part of the Norwegian breakfast? So many packets. #PainCloud2018 #Europe2018 https://t.co/XD03DdsyeV
My kind of conference when you end up talking song lyrics with pain geeks in an Oslo pub over a 🻠last night in #paincloud
Here’s the link to video
@MyCuppaJo @MaryOKeeffe007 @johnhurleyruan @DerekGriffin86 @Physio_Art
https://t.co/XPEmRx8JJE https://t.co/xRttrWjoO2
@siljeendresen coming up talking return to work from a pain psychology point of view #paincloud https://t.co/OQmjqDRWa7
Ready for day 2 at #paincloud2018 and first presentation by psychologist and researcher @siljeendresen about â€A new and innovative approach to help people with chronic pain return to workâ€
@Helmir68 @rtholopainen https://t.co/62rFwj2zBw
Now returning patients with chronic pain to work, looks to be very interesting! @siljeendresen #paincloud
For me this is the best slide and take home message from Day1 by @larsavemarie 👠#paincloud https://t.co/wkVfigDSSa
“Critical thinking is a way of realizing you were mistakenâ€
“Frame it positivelyâ€
#paincloud @larsavemarie https://t.co/jqDOieiKfU
| Sunday | to Top |
Silje: Norway has the highest sick leave in the world (2012). 39% of which is MSK-related.
Worth noting its higher population of elderly/disabled people...and generous welfare system #paincloud
Exciting day ahead at #PainCloud day 2! https://t.co/GHIE9CGeAr
Today’s programme @paincloud1 in Oslo #paincloud https://t.co/VI3AOj0yNR
Psychologist @siljeendresen is on. How #psychology can help people with chronic pain return to work.
#PainCloud2018 https://t.co/We4mZVan3f
Norway currently has the highest rate of job absence.
Why?
- High participation rate for women, elderly, disabled.
- Changing labor markets.
- Generous welfare system: Safety net yet a welfare trap.
@siljeendresen #PainCloud2018 https://t.co/Z5JUtwHlPW
MSK problems is the largest reason for work absence, followed by mental health problems.
@siljeendresen #PainCloud2018 https://t.co/c0yIPVfYzy
Silje: of those who were off sick with CLBP, 99% had other health complaints and 34% stated pain was not even their main problem...they reported work, family, sleep issues...#paincloud
@siljeendresen starting off the 2nd day at #paincloud A new and innovative approach to help people with chronic pain to return to work. Really looking forward to hear her talk!
Significant consequences for health in being unemployed: mortality, suicide rate, functional disorders, mental disorders. Good non-financial reasons to have a job @siljeendresen #paincloud
I would like to hear from others....
What was your take home message from Day1 from attending the #paincloud or following it via Twitter? https://t.co/ErcfJd4GbP
2/3 of patients sick listed for low back pain reported that pain was not their main problem @siljeendresen #paincloud
Silje: Research suggests work can be therapeutic but you may need a certain level of health or support to get there #paincloud
Silje: ‘Train and place’ schemes in Norway less successful than current Individual Placement & Support scheme which is more based on ‘place and train’ #paincloud
Silje: One IPS core principle is that it is the patient’s choice whether to return to work. There is often disparity in that the patient wants to work but clinicians have deemed ‘unfit’. They are also put in control of preferred type of work in this programme #paincloud
Silje: Benefit counselling part of IPS because people are naturally worried about the jump from benefits to work #paincloud
The Pain Toolkit Booklet has two dedicated pages regarding managing Pain at work and Returning to work with persistent pain
#PainCloud https://t.co/LcIycC10FH
Silje: There is continuous support throughout the process...and there is evidence it works #paincloud https://t.co/k9EVngsNO6
Silje: reported benefits of employment- £, self confidence, QofL, social inclusion, symptom management #paincloud
Silje: started as a scheme for mental health benefits patients but there is evidence it helps chronic pain patients too - Rødevand et al, 2017 (in press) #paincloud
Silje: Collaboration of all professionals involved in return to work is key - work in the same direction #paincloud
N=8 for this pilot but bigger study performed learning from the challenges #paincloud https://t.co/v0d9Hv3poo
Keep an eye out next spring for Silje’s next steps research - protocol already published #paincloud https://t.co/ZFpPSwxUxK
IPS model for Chronic Pain Pts
https://t.co/PeuFfkU9My
@siljeendresen
#paincloud
“Being out of work is bad for your health, work itself is good for you (provided there is a “good enough†work environment)â€
@siljeendresen #PainCloud https://t.co/3pL4Qwh8Od
How can we sleep better? Always some wisdom from this man 🤗 @jasonsilvernail #paincloud https://t.co/zxa4fQ2qeM
Jason: If we’re not changing behaviours, we’re doing it wrong! Patients spend far more time without us than with us #paincloud
Excited for @jasonsilvernail 🙌🙌 #paincloud
Jason: you can’t buy health with medicine #paincloud
You can’t buy health with medicine @jasonsilvernail #paincloud
Some great messages coming out of #paincloud2018 from @MaryOKeeffe007
We need to reinforce the positives! https://t.co/2NAbMENifl
We know the exercise research...sleep has the same benefits, do we endorse it enough? #paincloud https://t.co/H3z1DGjaYi
You are in the business of behaviour change, whether you know it or not. Focus on what the patient does outside of the clinic #paincloud @jasonsilvernail
The data that supports the benefits of exercise also supports the benefits of sleep. @jasonsilvernail #PainCloud
https://t.co/Xr732DZdFE
«You can’t buy health with medicine» Spend time helping your patients with healthy behaviours! @jasonsilvernail #PainCloud https://t.co/AigNauudId
Jason: Performance in job or performance relies on sleep. It’s one of the ingredients for good health but 1/3 of chronic pain patients report affected sleep #paincloud
Poor sleep behaviors correlates with higher prevalence of heart disease and stroke. Most are concentrated in the American South, Central US, and L.A.
@jasonsilvernail #PainCloud2018 https://t.co/m3rxd7eEzn
Jason: you don’t need to be a dietician to give good nutrition advice much like you don’t need to be a sleep expert to give good advice on it, but get to know the research! #paincloud
@johnhurleyruan decompressing his discs at #paincloud 🤠@DerekGriffin86 @PeteOSullivanPT @kieranosull @kjartanfersum #backpain https://t.co/AsLfNyIuzP
We’re so lucky to have @jasonsilvernail back on #PainCloud! A great presentator, inspirator, critical thinker and likable guy overall! 🙌 https://t.co/OOjCs8X4oq
Jason: Sleep is our recharge function for our physiology and cognition. Sleep allows us to move our short term memories from the ‘USB to the hard drive’ #paincloud https://t.co/n0iU1XHnRF
Memory consolidation disrupted by poor sleep 💤 @jasonsilvernail #paincloud
@jasonsilvernail presenting on sleep and pain - excellent discussion of the importance of sleep for many aspects of our life. #PainCloud https://t.co/P33oswxoZX
Psychologist @siljeendresen kicks off day 2 on #PainCloud - Work as therapy: presenting Individual Placement and Support for patients with chronic pain
This has such a great potential! 🙌 https://t.co/r52sbBcwxb
@johnhurleyruan @DerekGriffin86 @PeteOSullivanPT @kieranosull @kjartanfersum #movementvariability #paincloud https://t.co/Tnqu7ZAAPs
Preschoolers, teenagers and toddlers are like cats 🈠they need a lot of sleep 😴 🛠#paincloud @jasonsilvernail
What happens when we sleep: first half of the night key for deep sleep #paincloud https://t.co/kKYgVXa31W
Sleep 😴 hygiene is an odd term; there’s nothing dirty about sleep 😄 @jasonsilvernail #paincloud
Jason: let’s call it sleep habits not hygiene! #theresnothingdirtyaboutsleep #paincloud https://t.co/of9UGTddmU
Jason: caffeine is the most popular drug in the world and takes 6 hours to clear the system - even if you have adapted to its effects #paincloud
Jason: It’s no accident that if things are in the business of keeping you up, they’re blue... #paincloud https://t.co/0HoNH3g3xK
#Facebook & #Twitter colours are blue to keep you awake since blue could keep you from falling asleep. #PainCloud2018 @jasonsilvernail
https://t.co/HLOUI40zUK
Only sleep 😴 replaces sleep 😴 @jasonsilvernail #paincloud
Jason: waking up before alarm is goal - going back to sleep for a short time has little benefit #paincloud
Jason endorsing naps if you need one: take the longest time >20 mins you can afford and don’t be afraid of groggy sleep inertia, it will ease #paincloud
Jason: Help your patients to identify stressors. Help coach their behaviour #paincloud https://t.co/yFtfeqFECK
Jason: use process goals rather than achievement goals. Chip away at behaviour changes rather than SMART goals when it comes to lifestyle: it gets people started sooner #paincloud
Use process goals instead of achievement goals. Focus more on systems of processes instead of outcomes. Build desired habits of actions @jasonsilvernail #PainCloud
It’s not outside our scope of practice to speak to people about sleep and stress @jasonsilvernail #paincloud
We need to break out of our predetermined boxes. We can help people manage stress, sleep and diet, even if we’re not psychologists, dietitians or sleep experts. Know some science and learn how to coach people. #PainCloud @jasonsilvernail
Fantastic talk on the importance of sleep 😴 by @jasonsilvernail #paincloud
Challenge to all healthcare practitioners!
«You can deliver healthcare without telling whats wrong with them.»
🙌
@jasonsilvernail @paincloud1 #PainCloud
@SigMik @siljeendresen "Pain Management Programmes Conference 2007, Southampton: Pain and Supported Employment." Re-designing services is unfortunately a long slow business. #PainCloud
No tweet could do this talk by @jasonsilvernail justice on #sleep #PainCloud
ðŸ‘ðŸ‘ðŸ‘🤩
I am 25 years qualifies as a Physio and that’s the first lecture I have been to on 😴.And we know it is a sig contributor for pain.🤯
Note to self, reflect on this talk! It was 👌 https://t.co/brgfUstBz4
«Do you need to be a dietician to advice people about the benefits of fruit and vegetables?
You don’t need to be a psychologist or a psychiatrist to give advice about positive health behaviors like stress management or sleeping habits.»
#PainCloud @jasonsilvernail https://t.co/ihrURbWZAu
I really do hope they Can Come ip with an cure Soon - #cronicillness #sjogren #fatigue - Is hard to live with. #paincloud https://t.co/MhPU0oYA4s
Our bodily state heavily influences how we perceive our environment. Extremely relevant for chronic pain and fatigue states! @Tash_Stanton #PainCloud https://t.co/fLGneHNzde
Not quite the “nappucino†but think @Physio_Art has taken on board the concept of actioning behaviour habit change in the Oslo sunshine during lunch right now @jasonsilvernail
#napping #20mins #sleepbanking
#sleep #paincloud https://t.co/GVd75vkzWB
Just chatting to @jasonsilvernail over lunch about dignity in leadership and positive framing. Man of my own heart!
He’s heading to New York for the PT women in leadership conference with @karenlitzyNYC.
#paincloud
I’d love to go to that one! https://t.co/Kj5h0GX4vD
Todd: Pain is complex so treating it is a challenge - we have to consider multiple factors and it can be overwhelming #paincloud
Reductionism is not a fallacy, but it has major limitations in the understanding of complex conditions, like chronic pain. @ToddHargrove #PainCloud https://t.co/BZS2dqxI4e
Todd: ‘reductionism’ focuses on individual parts rather than the whole and it fails in chronic disease. The parts are interwoven #paincloud
@PrestonsHealth @PriyanikaJ @pdkirwan Link to my handout is on the #paincloud Facebook page!
Todd: an individual ant isn’t particularly intelligent but a group of ants is a highly adaptive unit. 🜠Studying an aspect of pain in isolation is not as useful as considering the person as a whole #paincloud
@PeteOSullivanPT @kieranosull @DerekGriffin86 @kjartanfersum @WimDankaerts @johnhurleyruan @CGMMaher @Tash_Stanton @BJSM_BMJ #backpain #paincloud https://t.co/yXgVn7wGCu
Todd: Low back pain is non-linear in its behaviour: small inputs can have huge outputs and vice versa. Also lots of small inputs can create a change, progress is non-linear too! #paincloud
Todd Hargrove demonstrating on how simple behaviours can lead to phenomenal changes in the system as a whole #paincloud #leadership #cspldp @ToddHargrove https://t.co/LIZ6S2UhmS
@ToddHargrove Positive vs Negative feedback loops in complex systems #paincloud https://t.co/GM5h5xD7ul
Positive feedback loops come under the control of a negative feedback system to restore homeostasis #paincloud https://t.co/2vrUYPUdqX
Todd: Positive feedback loops promote rapid change in the system and negative feedback loops promote stability #paincloud
Todd: positive feedback loops can be good (slide) or less progressive ie in the case of fear avoidance/pain #paincloud https://t.co/HsqMhhGSj0
Variability in a machine means dysfunction. Variability in a human doesn’t, and is a good thing. #paincloud @ToddHargrove
Machine variability is a sign of dysfunction -
Biological variability is normal and healthy -understand the kind of system you are dealing with @ToddHargrove #paincloud https://t.co/4GELDLA24y
Todd: we are not machines because we have Variablilty. Can’t think of the body as a machine because in machines input=output and their movement is constrained.
Variability is good because it makes us robust and adaptable #paincloud
Experts have natural variability in execution of motion - novices more rigid and less variable, more mechanical @ToddHargrove #paincloud https://t.co/6B9v1fms15
Super interesting talk from @ToddHargrove about complex systems and their relevance to chronic pain. #PainCloud https://t.co/Cg7hEuM3SG
This man has inspired me so much and I’ve always admired his excellence in making complex topics accessible! Great to hear him live!
#FanBoy 🤩 #PainCloud @ToddHargrove https://t.co/zUDvBcPKf2
«The landscape should get credit for the improvement» @ToddHargrove #paincloud https://t.co/10nAADDHIu
Love this idea - critical states in complex systems - conceptual framework for large changes in pain with relatively minor provocation. @ToddHargrove #PainCloud
Amazing talk on complex systems and understanding by @ToddHargrove - he has a great way of making complicated issues practically relevant #paincloud https://t.co/QfRMF1f3Wk
Todd: Attractor landscapes can help us understand the progression of pain #paincloud https://t.co/G5z3kRN7bM
Todd Hargrove is talking “complexity scienceâ€
I didn’t even know that was a thing!
#paincloud @ToddHargrove https://t.co/KcYhycMFOi
Todd: Self organisation theory works in sport. Maybe it’s best to create a good environment rather than change the way individuals move #paincloud https://t.co/T1YK6Z5cwT
Todd: if the focus chronic pain, we need to think more holistically. We need to be able to talk to people about these higher level topics #paincloud https://t.co/eLYfKXYs37
Simple: making sandwich, fixing car tire, putting bandage on cut
Complicated: making wedding cake, knee surgery, launching rocket
Complex: feeding the hungry, chronic knee pain, solving L.A. traffic
More complex: raising child, getting along w/ spouse
#PainCloud2018
@ToddHargrove killing it at #PainCloud #complexsystems https://t.co/rt4orbfAC6
This man has inspired me so much and I’ve always admired his excellence in making complex topics accessible! Great to hear him live!
#FanBoy 🤩 #PainCloud @ToddHargrove https://t.co/zUDvBcPKf2
Todd:machines are complicated, organisms are complex.
To solve complicated problem (rocket science, surgery) you need a reductionist strategy so knowledge is powerful.
Complex problems (raising kids, relationships) needs no ‘expertise’ but need to address many factors #paincloud
Complicated pain exists (ligament ruptures, fractures). Complex pain (chronic pain) however does not need a complicated plan but does need care to address multiple factors #paincloud
“Complex pain is not fixed in the same way as a car because it’s organic, we can evolve out if itâ€
“As therapists we are more like a gardener or a parent than a mechanicâ€
@ToddHargrove #PainCloud https://t.co/ZHSPDj7DWk
Complex problems does not have to be complicated (even though they often are). @ToddHargrove with a brilliant talk at #PainCloud https://t.co/uq1nZQuMva
Can’t sum it up much better than this slide! Advice from Todd to get comfortable with uncertainty
#paincloud https://t.co/kAGNmiXCFp
Research constrains the therapeutic territory to explore but you have wide freedom to explore in different evidence based areas @ToddHargrove #paincloud https://t.co/0EiKjJOaLo
5 major takeaways from talk by @ToddHargrove #paincloud
Getting comfortable with being uncomfortable : where have I heard that before?🤔#leadership #cspldp
@suehaywardgiles @SP_Physio https://t.co/0D86omj0Fh
Todd Hargove @ToddHargrove spoke about complexity. We humans are complex organisms, not machines which can be simply be fixed. In human things happen in non-linear way, rarely if ever in a linear way.
#PainCloud #Oslo https://t.co/QOZXvf4SHI
If complex systems theory piqued your interest - here’s more recommendations from @ToddHargrove to cram into your brain 👌🼠#paincloud https://t.co/uuf5gPFTLA
Derek ready to rip through Mary's talk yesterday now @kjartanfersum @DerekGriffin86 @MaryOKeeffe007 @kieranosull #paincloud https://t.co/jKv0PwtKX8
Full time clinician @DerekGriffin86
How do we apply this stuff clinically?
😊#paincloud https://t.co/L9n1Ptlh0w
People with LBP tend to have other pain sites @DerekGriffin86 #paincloud
Derek: widespread pain correlates with psychological factors, disability and reduced outcomes #paincloud
A back problem or a pain problem? Are we accounting for the other pain sites and the non MSK pain symptoms @DerekGriffin86 #paincloud
Derek: is it a back problem, a knee problem, a shoulder problem? Or a pain problem? #paincloud
Should we think of pain problems rather than back/neck/shoulder problem?? #paincloud @DerekGriffin86
Are we placing people into nociceptive and central boxes? Does this even help our management? @DerekGriffin86 #paincloud
Derek: we can’t isolate patients into groups, it’s a spectrum and we can’t assume the fit into a ‘box’.
Peripheral v central, mechanical v non-mechanical is more reductionist than the BPS model could allow for #paincloud
Mind-body distinctions are artificial, and they don’t (or shouldn’t) guide the treatment #paincloud @DerekGriffin86
Why are some exercises called mind body exercise? Doesn’t all exercise influence the mind and body. Mind and body can’t be separated @DerekGriffin86 #paincloud
@DerekGriffin86 - fantastic discussion of the problems with categorising problems and being reductionistic. “There is no patient that I see that does not have some pain with movement†- so are all mechanical? Excellent! #PainCloud https://t.co/0FWjxnlVzd
Pain is not a good barometer of tissue damage @DerekGriffin86 #paincloud
Specific anatomical diagnoses often not possible or helpful @DerekGriffin86 #paincloud
Derek: specific diagnosis often unhelpful and even in the case they are needed eg trauma, cancer, non-specific factors are important #paincloud
Are the clinical descriptions we use regarding pain really valid? Do they represent a true BPS approach? @DerekGriffin86 asking important questions at #PainCloud https://t.co/3D7ITWSd98
We tend to approach spinal pain differently to peripheral pain problems but where is the evidence that these are different? @DerekGriffin86 #paincloud
Need to move to a prognostic based framework @DerekGriffin86 #paincloud
Maybe we shouldn’t think so differently about the back vs periphery, or specific vs non-specific. Prognostic-based models might be more reaaonable. #PainCloud @DerekGriffin86
“These approaches don’t focus on specific diagnosis†@DerekGriffin86
Time for change
#paincloud https://t.co/JuIsITU1q8
Derek bringing in some themes from @MaryOKeeffe007’s session - are we walking the walk?
Lots of these ideas are similar, don’t look at the list as distinct interventions, he advises #paincloud https://t.co/UG48vcslTW
We hear of mental health problems, why don’t we hear of physical health problems? Is depression aâ€mental disorder?†Care with terminology! @DerekGriffin86 #paincloud
Who is at risk of developing persistent disabling LBP? @DerekGriffin86 #paincloud https://t.co/kcji6axjoi
“Are we wasting time trying to do specific tests instead of looking at identifying patients at risk of disabling pain†@DerekGriffin86 #paincloud https://t.co/IW3z2edXXp
Who develops persistent, disabling low back pain? 😬
- Passing coping (e.g. relying on therapist for treatment)
- Perceived lack of control over their pain
- Low expectations of recovery
- Negative beliefs
- Lower social class
#PainCloud2018 @DerekGriffin86
Loneliness and lack of social support very important in the pain experience @DerekGriffin86 #paincloud
Derek: Biological. Psychological. Social. This is reductionist too! The BPS model involves the neuroimmune system and while pain can be one physiological symptom, there are many more and this can be where psychology and social factors interact #paincloud
Derek: delve into the interacting features and predisposing factors to pain #paincloud
Multimodal is not the answer. Simply combining a few different treatments is not how it works @DerekGriffin86 #paincloud
Derek: fear is psychological but may lead to a protective response and then a biological motor output/reduced bending #paincloud
What are we targeting with therapy?
The stressor? The stress response?
Or.......
“Can we equip people to increase increased coping ability?†@DerekGriffin86 #paincloud https://t.co/JefPe7Mlgb
Derek: purpose of Pain Education is to drive change through behaviour change. It is not a standalone intervention #paincloud
Explain pain can equip people with what they need to facilitate behaviour change, regardless of hos useful it is as a stand-alone treatment #paincloud #explainpain @DerekGriffin86
You can’t educate somebody you don’t understand. Listen to the individual’s narrative. @DerekGriffin86 #paincloud
You can’t treat somebody that you don’t know, or don’t understand @DerekGriffin86 #paincloud https://t.co/W9oyUfNjTV
More than anything else, explaining pain is creating a foundation for behavioural change. @DerekGriffin86 #paincloud https://t.co/iGo1x519E2
Make pain education relevant to the individual @DerekGriffin86 #paincloud
Derek: Listen to the patient’s story, use their own history to relate their experience to their pain #paincloud
Exposure isn’t just about movement; it’s about exposing people to multisensory contexts @DerekGriffin86 #paincloud
Graded exposure - more than movement! Individual (relevance, preference etc) and contextual factors (multiple context, challenging feared movements specfically, etc) can be tailored and modified. Reflect during intervention #PainCloud @DerekGriffin86
Explicitly challenge movements deemed threatening @DerekGriffin86 #paincloud
Create a prediction mismatch. Move in multiple contexts in multiple ways to drive variability and unpredictability @DerekGriffin86 #paincloud
Derek: brains learn from error, not what it’s already good at. Exposure has to be to be broad and individualised to a person’s movements deemed threatening #paincloud
Discourage safety behaviors and encourage open disclosure/reflection during exposure @DerekGriffin86 #paincloud
Use external cues which discourage focus on the body. Choose meaningful/purposeful activities @DerekGriffin86 #paincloud
We tend to view pain as a negative thing. But pain is a protector but it can be doing too good a job at protection @DerekGriffin86 #paincloud
Pain as a protector - can be hugely useful to reconceptualise from pain as a enemy (if used properly) #PainCloud @DerekGriffin86
Educate about pain. Protector versus enemy @DerekGriffin86 #paincloud
Need to plan flare up control strategies @DerekGriffin86 #paincloud
Derek: help people to accept their pain for what it is- an overprotector, a protector that has got too good at its job rather than the ‘Enemy’. Help reduce pain itself as a stressor #paincloud
Super to see the range of research by @DerekGriffin86 @MaryOKeeffe007 @johnhurleyruan from @AlliedHealthUL @UL at #paincloud
A flare up of pain is an opportunity for experiential learning @DerekGriffin86 #paincloud https://t.co/VsE06u8ZQa
Flare ups are a good opportunity for experiential learning and self reflection IF they understand that pain is a protector @DerekGriffin86 #paincloud
Using flare-ups for experiential learning can be very useful. You encounter a crossroads. Do you take the path you normally travel, or can you explore new ways and learn #PainCloud @DerekGriffin86
Derek: Pain episodes are learning experiences - help people learn from them and promote control #paincloud https://t.co/cN79ucOb3z
Absolutely fantastic presentation by @DerekGriffin86 🙌 What a brilliant clinician #paincloud https://t.co/zs6mlbcleG
My observation from @paincloud convention #paincloud
I don’t think I’ve ever heard such intelligent questions from the audience in a conference/course
👊🤓👩â€ðŸŽ“👨â€ðŸŽ“👌 https://t.co/6lpgD1yjJG
Great article shared by @DerekGriffin86
at #paincloud.
Great way to learn to connect the dots for people.
https://t.co/MVcYVJvssJ
And that’s it from Pain Cloud! A brilliant conference if you get the chance to attend. Trending in Norway, our work here is done 😉 #paincloud #TPMP https://t.co/bSjvmKMvsH
Yes setbacks are opportunities to learn, although we don’t see it like that at the time.
The man or woman who makes no mistakes, doesn’t make nothing #paincloud https://t.co/GDHRTX3bR0
Derek: Pain episodes are learning experiences - help people learn from them and promote control #paincloud https://t.co/cN79ucOb3z
Honest and valuable views about real life experience about suffering yesterday from brave and sweet @MyCuppaJo She was main reason for me to participate to #PainCloud You are what you are and be brave of that. #human #nomore #noless https://t.co/kvhhVQkdnP
This nappucino is really taking off. What did you say about behaviour change habit @jasonsilvernail ?
Contagious behaviours happening here in Oslo @johnhurleyruan #paincloud https://t.co/Nd8Dkfjr2j
I have really enjoyed the #paincloud convention not only the excellent talks but meeting likeminded people from all the corners of the world🙠want to sum it up with a picture @ToddHargrove had under his presentation👌 https://t.co/rGyvjxeETg
I have never been to a conference before where I have taken 📠notes in the bar......@paincloud1 @Physio_Art
#paincloud #thinkingdifferently #thinkingaboutthinking https://t.co/ixFDtSe1sA
One important take-home measage from this weekend: we don’t have the perfect answers to deal with pain, but we know a fair bit about what we need to do less of, and we still have some ways to wander there (messages regarding pain and movement etc) #paincloud
#EarthDay avicii Ranheim Trier Navarsete #Oslo #paincloud Rosenborg https://t.co/aLzRkyTQse
We’ve just introduced this intuitive wise clinician 👌 to Twitter @paincloud1 #paincloud
Pls can u give her a follow? https://t.co/grBsix0ST0
Sharing is caring
#paincloud https://t.co/D3FH32FA9X
#paincloud was 2nd trending in Norway 🇳🇴 👊
And this tweet was the 2nd top tweet of the #paincloud (or at least that’s what @felicitythow told me!)
@MyCuppaJo https://t.co/SMzDuZyCHK
This made me laugh. If you haven't already, check out the tweets from #paincloud many great quotes, slide shots, and references! https://t.co/St2tDZerY8
Sleep 😴 hygiene is an odd term; there’s nothing dirty about sleep 😄 @jasonsilvernail #paincloud
Some really interesting information coming out of #paincloud at the moment. Do yourself a favour and have a look and follow @paincloud1
@SanDiegoSummit Beautiful people at #paincloud, so inspiring talks (I think the pic was in @DerekGriffin86 lecture)
Tried out a workshop with @LaurenDAustin and cut my hours in half. #paincloud #Horses #ArtOfTheDay #paintings going to have some more #funtimes in the future. https://t.co/zkVrdVaMFY
Ok everyone. If you have been basking in sunshine and not on twitter then immediately take a look at the following hashtags.
There is some absolute gold in them from Friday-Sunday!
#paincloud
#TheBigRs
Get involved!
Discussing how to target societal beliefs surrounding the meaning of pain was a key focus of this weekend @paincloud1 #paincloud
Targeting policy makers, healthcare systems, governments and the media top priorities https://t.co/nQexVF3Q9K
Prince was struggling with pain after years of intense performing and addicted to pain medication. There are more effective and less harmful ways to manage ongoing pain. https://t.co/OjpM0qfKoQ @australian
Or should we call it “simplicity science” @DerekGriffin86 #paincloud https://t.co/5EPlaiKhjR
Todd Hargrove is talking “complexity science”
I didn’t even know that was a thing!
#paincloud @ToddHargrove https://t.co/KcYhycMFOi
I've found movement good for chronic pain. Mainly muscle spasm and tendon pain. #runner #LondonMarathon #marathon #ultra #triathlon #swimming #diving #boxingnews #Judo #backpain #BodyBuilding #Taekwondo #gymlife #paincloud #chronicpain #Inflammation #MSK #physiotherapy #physio https://t.co/TBrGw4FiTI
Did you know that movement is an anti-inflammatory? @PrestonsHealth @Physio_Art https://t.co/TQax91GsDt
Not only was Pain Cloud ace but all the live tweets/retweets and likes helped to make #Paincloud… https://t.co/4OEks8vjgt
Cont., Thread: #CriticalThinking –––medical decision making
Speaker @larsavemarie talk at #paincloud conf.@ centrality of critical thinking in improving clinical practice, his 'rules':
#1 Don't assume ppl are logical reasoning individuals
(types of competence-worst:unconscious) https://t.co/9rYuzm5NIW
Just sat in an Oslo cafe with study buddy @Physio_Art going through your sleep presentation @jasonsilvernail
Thank you! #paincloud https://t.co/q1XQLciplD
@COPSSwimFast
Sleep advice for the swimmers! From Oslo @jasonsilvernail #paincloud
@markstevens36 @Anabennett14 https://t.co/TragTQWs1z
Cont., Thread: On #CriticalThinking
Via @larsavemarie /#paincloud
♦️clinical reasoning, a skill, honed over yrs of practice
♦️System 1 vs System 2 thinking
♦️DX error linked 2over-reliance on System 1 (intuitive) thinking over more deliberate cognitive approach of System 2 https://t.co/GfusYuIeKc
Cont., Thread: Critical thinking –––– medical decision making #CriticalThinking
Speaker @larsavemarie /#paincloud
His definitions 🔽, a process built on understanding of human thought systems to systematically evaluate one's own and others beliefs
"take a cricket bat to your own" https://t.co/C1WKgvA1uH
Cont., Thread: Critical thinking –––– medical decision making #CriticalThinking
Speaker @larsavemarie /#paincloud
In making statements, specify whether the statement is a:
♦️subjective opinion• claim
OR
♦️objective truth• claim
Cont., Thread: Critical thinking ––––medical decision making #CriticalThinking
Speaker @larsavemarie /#paincloud
#Bias: "we are all bias"
REC:
From Mindless to Mindful Practice — Cognitive Bias & Clinical Decision Making ––Pat Croskerry, M.D., Ph.D.
https://t.co/S0bi514EHA @NEJM https://t.co/OKgwDjAI8T
Cont.,Thread: Critical thinking ––medical decision making #CriticalThinking
Speaker @larsavemarie /#paincloud
Five cognitive biases to avoid: Overconfidence, Bandwagon Effect, Sutton’s Slip (going for obvious dx) Search Satisfying ('Eureka' moment),
Outcome Bias (ignores process) https://t.co/eFpiJxbQDp
Cont.,Thread: Critical thinking ––medical decision making #CriticalThinking
Speaker @larsavemarie /#paincloud
In decision making, take time to gather the data ––prior to theorizing. (O/w too easy to twist the data to fit 'chosen' theory.) "To know the mind is to conquer the mind" https://t.co/MuZLzHZije
Cont.,Thread: #CriticalThinking –– & medical decision making
Speaker @larsavemarie /#paincloud
Overconfidence bias:
"believing one knows more than one does, acting on incomplete information or hunches and prioritizing opinion and authority over evidence." ––Bordini et al 2017
Cont.,Thread: Critical Thinking –– & medical decision making #CriticalThinking
Speaker @larsavemarie /#paincloud
#Cognitive #error and emotion ––
"We are especially prone to cognitive errors when we deal with things we have an emotional attachment to."
Cont.,Thread: Critical Thinking –– & medical decision making #CriticalThinking
Speaker @larsavemarie /#paincloud
🔽
"Outcomes measure outcomes, NOT effects of intervention."
Full:
https://t.co/q11MCBVLXN
Australian Journal of Physiotherapy 2005 Vol. 51 https://t.co/DXfn5MrKcD
Cont.,Thread: Critical Thinking –– & medical decision making #CriticalThinking
Speaker @larsavemarie /#paincloud
Two recommendations (see image)
Testing Treatments ––– cc #EvidenceLive @EvidenceLive https://t.co/eHiNaRP8gq
You’ve really made me think @MyCuppaJo
This book just drew me in....
#paincloud #artistherapy #pain
This website was highlighted throughout Joletta’s inspiring talk in Saturday @paincloud1 :
https://t.co/dEAC0ryieT https://t.co/vDDZScYnmq
Why is on the earth , Marriage of best friend and exam are at the same time, everytime????😬😬😬😬😬😬
#MondayMotivation
#TotalDhamaal
#paincloud
@JanetThomas47 @physiotalk Yes, I walked into #paincloud this weekend and knew lots of the audience purely from Twitter. Even better that it was across international and professional boundaries #physiotalk
Persistent pain in an elite athlete. Fascinating insight here #paincloud @2505JC @DerekGriffin86 @AidanTighe https://t.co/KD2cEMiG1K
From the next big thing to a forgotten, forlorn athlete - Kevin Mulcaire has had it rough the past few years. Caught up with him a long way from home to hear his story. https://t.co/Ndm6WlxUqB
100% agree @jerry_osteopath. It was a fantastic display of a deep understanding of the field of pain and BPS model of care by @DerekGriffin86 🤗 #paincloud https://t.co/utPB11ZRAY
Excellent closing presentation by @DerekGriffin86 Just bloody impressive insights about pain and BPS model. We need to understand that only patients holds the keys to open up doors out of suffering. Its not only pain we should address. #puregold #thanks https://t.co/EIYzFMR4PK
I respectfully disagree with this @CWrightPhysio
We are missing a whole world of opportunity if we don’t appreciate Twitter is a platform to engage with patients, purchasers, professional groups etc to showcase what we do
1/2 #paincloud https://t.co/9pae1bfX61
@PrestonsHealth @ashjamesphysio Twitter for chats with fellow clinicians, FB for reaching the general public.
@CWrightPhysio @ashjamesphysio 2/2
How to change societal pain messages was discussed at length at #paincloud with @MaryOKeeffe007 and @DerekGriffin86
The answers might lie with purchasers and patients demanding us (ie healthcare industry)to change
All 👀 are watching us here: it’s a real change to influence!
@ashjamesphysio @CWrightPhysio @thecsp Just look at how #paincloud trended as no2 in Norway. That will have engaged people well beyond healthcare.
We have to change to system thinking: and how we can influence wider than just ourselves. Let’s face it, we are preaching to the converted anyway thro Twitter!
@CWrightPhysio @ashjamesphysio @thecsp No it trended #paincloud as No2- see @TPMPodcast tweets about it. I was discussing this with @felicitythow on Sunday night (awesome digital knowledge btw Felicity!)
Every one of us has a part to play on this!
Back to work today. No louder yet softer voice has inspired me more than listening to @MyCuppaJo @paincloud1 #paincloud
I am brave. I am bruised. I am who I’m meant to be. #thisisme https://t.co/kK672G8AIB
The most powerful presentation on pain I have ever heard in my life @MyCuppaJo 💪(and believe me, I have heard a lot!)
Honest. Brave. Vulnerable. Courageous.
Thank you 🙏 for leading the way.
Hearing the patient perspective at conferences has to be the new thing!
#paincloud https://t.co/86SSuUuhhe
I got told to look at the #paincloud thread the other night. I don’t work in MSK but deal with back pain in A&E quite a bit. But this slide makes me both chuckle but also makes me wary of the language I use. https://t.co/YHZA4HDw99
The first rule of Critical Thinking 🤔 club 🙌🙌🙌 #paincloud @larsavemarie https://t.co/ZUkHQH9sxk
Again a #paincloud slide has made me think a little bit about how I practice, despite not being in an msk field. https://t.co/UbRgSIJrfq
“Essential reading for all physiotherapy students”
BTW: I stood consider myself a student: note to self. Read this paper!
#criticalthinking #paincloud @larsavemarie https://t.co/Q542fCZuXC
Thanks to Ole (@paincloud1) for a fantastic few days in Norway. You have set the bar very high. It was great to meet up with great colleagues from around the world. It was a pleasure to be involved in this great event. Thanks to @NickNgfreelance for the great pic! #paincloud https://t.co/ySG5ibBTH3
Heading home from #PainCloud 2018. I think these smaller regional conferences with top speakers and more time for interaction are the wave of the future. Huge thanks to @OleMsal for putting on an amazing conference and cabin getaway afterward! https://t.co/PqiLt8mS1r
@jasonsilvernail @OleMsal I’m so inspired by the whole entity of #paincloud as well as its intent.
Your talk was 🤩Jason and I have already organised some family’s &kids to come round to my house to talk them through “daily download” and “wringing the sponge”concepts
How did I get to 43 and not know that?
Just shown this slide from #paincloud @ToddHargrove to a patient to help the make sense of their pain flares
It helped validify his own discrepancies in the story he had previously been given
He “got it”
Thanks Todd! (Now onto the @kieranosull test next time around!) https://t.co/0ZZHKaz3dG
@ashjamesphysio @TPMPodcast @AdamMeakins @JackAChew @physiojack @rehabrich @MaryOKeeffe007 @tomgoom @thomas_jesson I understand the concept but as per my #paincloud talk, I don't like this distinction between bio/psycho/social. Nothing fits neatly into either category and I believe it to be reductionist.
Brilliant, thx Lars #paincloud https://t.co/wx3Q1V1jaO
@PrestonsHealth This also:
https://t.co/TBU05HV2T2
"You are in the business of behaviour change whether you know it or not."
@jasonsilvernail. Some great #paincloud tweets coming courtesy of @LarsAvemarie . This one from Jason Silvernail absolutely nails it. https://t.co/GND5nmRITd
Relieving patients' pain with expectation interventions: a meta-analysis. - PubMed - NCBI https://t.co/g6g3abZxn2
このままこの治療すると絶対良くなる！良くなる！良くなる！
→
良くなったつもり
＃良くある話 #paincloud