Hope, Goals and Jimmy Fallon

I heard a great story from a patient of mine last week. It’s great because it involves my absolute favorite celebrity on the planet: Jimmy Fallon. It’s also great because as the patient and I talked pain neuroscience education (PNE), his story wove right into a point I was trying to make with him, and one I think…

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REALLY!?!

The longer I practice and the more I learn through reading the research about various interventions, I look at some treatments that are being delivered and say, REALLY!?! But that gets me wondering: “What treatment does my patient REALLY need?” I’m not asking what treatments have been shown in study to get people better or what treatments that I…

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Facing Fear and Finding Safety

For far too long I have undervalued the importance of acknowledging fear in the lives of patients with pain. I have always given fear the token head nod, acknowledging its presence; but my lack of deeper understanding has caused many missed opportunities for treatment. Facing fear is to embrace fear with the intention to disrupt it. This blog considers two…

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Fear & Loathing in America

In many ways, there has never been a better time to be alive. In this NY Times piece The Dalai Lama & Arthur C. Brooks do not sugar coat the fact that serious inequalities and violence persist in our world, however, they also describe how fundamentally strange it is to see such anger, political frustration, and anxiety about the future…

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Therapeutic Ritual

Rituals are a sequence of activities, performed in a sequestered place, and performed according to set sequence. Rituals are something we all partake in as part of living in society. We just had the centuries old ritual of going door to door wearing customs and asking for candy on October 31st. We also saw the breaking of the 108-year…

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Control versus Influence

I came across an interesting concept in an excellent book I recently read – CBT for Chronic Pain and Psychological Well-Being. In the session looking at “orientation to change”, Dr. Carlson points out that when an individual feels they have some control over a situation, they are more apt to act and advocate for themselves. This thinking is in alignment…

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It is more than just harmful, it is wrong!

Frequently on this blog we have discussed the harms inflicted by over-imaging, over-surgerizing, and over-prescribing opioid medications in the management of musculoskeletal disorders.  We have also discussed how care pathways that focus on PT First reduce imaging, surgery, and drugs and result in lower health care costs.  First and foremost as a clinician and researcher I believe…

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Patience, Patients

I have noticed a gradual rise of impatient patients and wonder why. I perceive a blurred reality for many patients who want to feel better “now”. I hear patients who are wearied of their pain problem and expect it to be gone the moment they start treatment. Many times the pain has been present for months, but once the decision…

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