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Diagnostic triage in low back pain

Low back pain (LBP) is one of the most common musculoskeletal problem encountered by a clinician. For the purpose of screening and diagnosis of LBP, a diagnosis triage has been proposed for patients when first presenting to a clinician. The goal of diagnostic triage is to exclude non-spinal causes of back pain and to allocate […]

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Outcome measure – talk at WCPT conference

It was an excellent opportunity to present at a how to… seminar on “Outcome Measures” at the World Confederation for Physical Therapy (WCPT) Congress 2017. Outcome measures are important for assessment in clinical practice and research. Patient-reported outcome measures (PROMs) have now become very common for the assessment of a variety of constructs such as […]

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Patient-Specific Functional Scale (PSFS)- Nepali version

Patient Specific Functional Scale (PSFS) is one of the most frequently used outcome measures to assess physical function in individuals with musculoskeletal pain conditions. It is an easy to use measure because it only asks patients three to five items that they find difficulty doing on a scale of 0 to 10. As patients choose […]

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Pain Rating Scales- Nepali versions

Pain rating scales Different measures exist to assess intensity of pain which are suited for different individuals based on age, education and culture. Read this previous blog on different measures for assessment of pain intensities. They are translated and adapted to assess pain intensity in Nepalese with pain. Numerical Pain Rating Scales are among the […]

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Consensus statement on Patellofemoral pain: Part 1

Patellofemoral pain (PFP) is a common condition of the knee that is characterized by the pain behind and around the patella. It is present in 7 – 28% of population and is slightly more common in women. As different researchers define the condition differently in their research, so do the clinicians. This results in difference […]

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Initiative to develop outcome measures in Nepal

Outcome measures are really important aspects of any practices in health care system. For example, vital signs are routinely assessed in patients admitted in hospital; e.g., temperature, respiratory rate, pulse rate and blood pressure. These are very important to assess the condition of a patient and now is an established rule. Prognosis of the patient […]

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Reflection on the “Mulligan Concept” Workshop

It is very important for all clinicians to reflect on things that we learn may it be by undertaking a course or what our patients teach us every day in the clinic. By reflection, I mean, analyzing what did I learn, what is good about this, how can I use this in my patients, how […]

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Classification of Low Back Pain based on Neuropathic, Nociceptive, or Central Sensitization dominance

Low back pain (LBP) is a heterogeneous disorder including patients with dominant nociceptive (e.g., myofascial LBP), neuropathic (e.g., lumbar radiculopathy), and central sensitization pain [1]. Nociceptive pain is defined as “pain arising from actual or threatening damage to non-neural tissue and is due to the activation of nociceptors, or as pain attributable to the activation […]

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How can we measure pain?

The ultimate aim of any clinician is to relieve afflictions of the patient which is measured in terms of pain. Pain is a psychological phenomenon and naturally there are several facets central to its perception [6]. These include intensity, duration, interference with activities or disability, affect, tolerance, fear avoidance, catastropizing etc. There are multiple validated […]

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Hidden contributor of pain in clinical practice – “Catastrophizing”

The experience of pain is a complex interplay between psychological, biological, and cultural factors [1]. Individual who experience pain from any surgical procedure or from any injury to the tissue tends to distress or pain. But question arises why the person with same type of injury or surgery tend to have different level of pain […]

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