I was delighted to be invited to write a clinical update as part of the International Association for the Study of Pain’s 2025 Global Year 🌏
Check it out 👉 journals.lww.com/painrpts/ful...
One-Page Patient Fact Sheets for Low Back Pain in Primary Care url:jamanetwork.com/journals/jamanetworkopen... 📚
World Physio Congress 2025 highlights:
-Seeing physios in diverse settings, esp crisis/emergency settings
-Seeing the knowledge from physios in Gaza on trauma-informed care
-Emphasis on multi-level determinants affecting health
Great to connect with clinicians from the Critical Physio Network 💪
"Critical" sometimes causes confusion. It refers to challenging taken-for-granted assumptions & expose entrenched, asymmetrical forms of power. It is primarily used in physio to create space for new forms of thinking & practice (e.g. challenging the primacy of the body-as-machine).
In critical physiotherapy the “human” is deeply political: humanity is embedded in history, shaped by it and myriad social forces, & conditioned by relations of power in which
some are able to assert their status & privilege at the
expense of others.
pubmed.ncbi.nlm.nih.gov/37688439/
unnaturalcauses.org/assets/uploa...
Tackling health inequities requires widening our lens to understand how jobs, working conditions, education, housing, social inclusion & even political power influence individual & community health.
One way to understand what Marmot calls the “causes of the causes” is to ask new questions:
Australian Pain Society Conference done! #AusPainSoc
Presented on the mechanisms of patient-led goal setting & pain science education ✅
Received updates on IASP 2025 Global Year through Australian lens (ISSHOOS published soon: www.isshoos.org)
Informative work at the 'rural realities' workshop
Figure 3. Potential avenues to apply a multilevel conceptualization of social aspects of pain to advance equitable pain prevention and management.
pubmed.ncbi.nlm.nih.gov/38897311/
Figure 1. Examples of contextual intersectional health inequities.
pubmed.ncbi.nlm.nih.gov/38107758/
Social is often positioned as a separate domain to people's health, a binary of medical/psychological, or conflated with individual.
Social isn’t just personal context, but also social structures, ideologies & institutions that privilege interests of dominant groups
www.jpain.org/article/S152...
That’s awesome! It was a really lovely crowd ☺️
-Examples of co-design with Māori people and their value for other forms of knowledges can be valued more in Australia
-Difference between reflection, critical reflection & critical reflexivity
Some conference reflections:
-Important to focus on the demands the health system puts on patients instead of referring to patients’ “low health literacy” as the reason for challenges (Susan Reid’s work)
I had the pleasure of presenting at the New Zealand Pain Society Conference this week 😍
I spoke about the complexities of clinical practice when providing evidence-based practice to people with chronic low back pain & linked them to the conference theme of “equitable outcomes in pain care”
When someone receives treatment for a MSK pain condition - the total treatment effect encompasses the specific effect of the treatment, contextual effects, and non-specific effects.
www.sciencedirect.com/science/arti...
What determinants play a key role in the lived experience of persistent pain and recovery?
www.sciencedirect.com/science/arti...
Political, economic, and cultural systems regulate social relations at a societal level, and define resource distribution, impacting pain prevalence and treatment access.
Ideas are organised into three broad categories; justice, access and knowledge
www.sciencedirect.com/science/arti...
Would love to see!
4 of the themes describe what it means to live with chronic pain & 6 of the themes describe what it means to be on a healing journey with pain.
“A Healing Journey with Chronic Pain: A Meta-Ethnography Synthesising 195 Qualitative Studies”
academic.oup.com/painmedicine...
“Listen to me, learn from me & hear what I’m telling you, it makes me feel like my concerns have been understood”
“Provide a holistic approach to my care that is tailored & looks after my physical, mental, occupational, social, spiritual & intellectual needs”
pubmed.ncbi.nlm.nih.gov/35384928/
“System (eg. biomedical orientation), organisational (eg. key performance indicators) and professional (eg. identity as expert) factors compete with person-centred rehabilitation”
Great work by Prof Nicola Kayes
journals.sagepub.com/doi/10.1177/...
It often takes me a few goes to understand words like ontology, epistemology, positivist and constructivist…The breakdown in the paper is gold!
pubmed.ncbi.nlm.nih.gov/34457699/