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Low back pain update presentation at NEPTACON 2018

I flew to Nepal last week to deliver an invited talk on “low back pain- update” at Nepal Physiotherapy Association Conference (NEPTACON 2018). I received an overwhelming response: houseful presence, many questions, request to conduct longer sessions demonstrating how to educate/reassure patients with low back pain.  Although I requested for an hour session, due to […]

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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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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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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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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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Why does an old knee hurt?

Old knees are mostly painful due to a complex problem called the osteoarthritis (OA). It is one of the most common musculoskeletal disorders, which refers to clinical syndrome of joint pain accompanied by varying degrees of functional limitation and reduced quality of life (1). It affects more than one-third of persons of age more than […]

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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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Assessment of Pain in clinical and experimental setting

Pain assessment has always been a challenge for researchers for many years. They have always tried to quantify pain. Quantitative sensory testing (QST) evaluates the integrity of the entire sensory receptors. It is found to be a reliable and relatively reproducible. Though QST is a subjective test, recent brain imaging studies provide strong evidence that […]

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Should we worry about “how much it hurts” in Chronic Pain?

History of pain management suggests strong value of focusing on pain intensity as the goal of treatment. This is true for cancer pain towards the end of life and probably for acute pain with injury or pathology. However, for pain without obvious pathology or trauma, addressing elimination of pain may not be right goal of […]

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