Post-surgical inflammatory neuropathy has been studied by these authors as they felt that other mechanisms maybe at play other than the usual mechanical factors (stretch, compression, contusion, transection). They analysed the clinical features, nerve conduction, imaging and biopsy of the nerves demonstrating some interesting findings indicative of an inflammatory-immune response. For example, Staff et al. (2010) found increased nerve size, abnormal biopsy (increased epineural perivascular lymphocyte inflammation, microvasculitis, ischaemic nerve injury and axon degeneration). Those treated with immunotherapy showed good improvements in pain and nerve function supporting the notion of an immune response.
Typically this kind of neuropathy is found remote to the surgical site and presents at a median time of 2 days (0-30 range). This does not fully explain a presentation that occurs on the same limb.
Overall this study suggests that the inflammatory-immune response is not uncommon and should be considered as a mechanism to guide treatment. The authors also point out that it may be difficult to distinguish between a mechanical cause and an inflammatory cause and therefore a biopsy would be required to confirm. Of course there could be concurrent mechanisms that we know occur in LBP.
Thursday, 30 September 2010
Tuesday, 28 September 2010
How to be happy
Editorial: Don't get too happy
It's good for your health, it makes you smarter – and our brains are hard-wired for it. New Scientist counts our reasons to be cheerful
DOOM and gloom are the order of the day across most of the western world. Economies are faltering, the cost of living is going up and many people's real income is falling. For some, unemployment is a reality now or in the near future. If the pursuit of happiness is supposed to be one of our goals, prospects appear bleak.
Take a closer look, and it isn't that simple. In fact, economic hard times have little impact on how happy most people feel. Indeed, it would appear that we humans are built to experience happiness, and understanding why is helping us work out what enhances our feelings of well-being. It even points to ways we can adapt to cope with the hardships the recession may bring, and keep smiling whatever happens.
One thing that is clear is that once life's basics are paid for, the power of money to bring happiness is limited. In fact, it can be positively harmful to our sense of well-being. Jordi Quoidbach of the University of Liège, Belgium, and colleagues recently asked a group of people to taste a piece of chocolate in their laboratory. They found that the wealthier members of the group spent less time savouring the experience, and reported enjoying the chocolate less than the subjects who weren't so well off. The same was also true of one group in a separate experiment. This time, half the people had been primed with images of money before they tasted the chocolate. These participants enjoyed the tasting less than a group who had not seen the images, suggesting that just the thought of money is enough to stem our enjoyment of life's simple pleasures (Psychological Science, vol 21, p 759).
So just what is it that makes us happy? Happiness can take the form of many different positive emotions (See "Happiness is..."), and some hints of what makes us happy may come from work that questions why these emotions first evolved. The answer isn't as obvious as it is in the case of negative emotions. These are clearly beneficial in the rough and tumble of survival: anger readies us to fight an opponent, fear makes us run away from danger, and disgust steers us away from contaminated foods and other sources of infection. Although there is no shortage of evidence that feelings of pleasure - obtained by finding a tasty meal or a sexy mate, for example - are important in rewarding and consolidating beneficial behaviours, it is harder to explain how the more diffuse positive emotions such as awe, hope or gratitude evolved.
This troubled psychologist Barbara Fredrickson of the University of North Carolina at Chapel Hill, so she started looking for evolutionary benefits that pleasure might confer. "I thought there must be more to it than this," she recalls.
Fredrickson's "broaden and build" theory proposes that happiness and similar positive states of mind improve our cognitive capacities while we are in safe situations, allowing us to build resources around us for the long term. That's in marked contrast to the effects of negative emotions like fear, which focus our attention so we can deal with short-term problems. "Positive feelings change the way our brains work and expand the boundaries of experience, allowing us to take in more information and see the big picture," Fredrickson argues.
Positive feelings change the way our brains work, allowing us to take in more informationSince she proposed it in 1998 in the Review of General Psychology (vol 2, p 300), her theory has gathered a wealth of experimental support. Eye-tracking and brain-imaging experiments, for example, have revealed that positive moods increase and broaden the scope of visual attention, helping the brain gather more information.
A happy solution
Feeling good has also been shown to improve people's creativity and ability to solve problems. In one experiment, subjects were shown a video of comedy bloopers to lighten their mood, before being presented with a practical problem involving a box of matches, a box of tacks and a candle. They were told to attach the candle to a pinboard in such a way that wax didn't drip on the floor (the solution is to use the matchbox as a plinth for the candle). The experimenters found that people who had viewed the comedy clips were more likely to solve the problem than controls who saw a mathematics documentary intended to put them in a more neutral mood (Journal of Personality and Social Psychology, vol 52, p 1122).
Other experiments have found that a good mood improves people's verbal reasoning skills (Proceedings of the National Academy of Sciences, vol 104, p 383). And various studies have shown that when people are in a good mood, their social skills improve: they become more gregarious and trusting of others, and deal more constructively with criticism.
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Optimistic Twaddle?
Tue Sep 28 21:29:48 BST 2010 by Cannonfodderson
Here we have some 'cheer up your not dead yet' kind of optimistic nonsense and yet there's another article on your website saying there's only 5 billion years till the end of the Universe.
Optimism ? I'm not too happy about that
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How old do you feel?
We all know of people who look fantastic ‘for their age’. How do some individuals achieve this status whilst others feel twice their age? There are a number of physical and psychological factors that affect the process of ageing such as general health and wellbeing, disease and our own perception of our age. It is this latter point that we shall focus upon with a growing body of scientific literature identifying the very real physiological links between thoughts, beliefs and the physical body.
Beliefs are grooved through our upbringing and molded by experience. Behaviours are driven by our beliefs and therefore the choices we make depend upon what we believe to be ‘true’. The importance of this in terms of ageing is that if we believe that we are ‘old’, ‘past it’ or ‘getting on a bit’, then typically the way that we go about our business will reflect this attitude. This of course includes our outward appearance to the world. Believing that you are ‘old’ may lead to the choice of clothing that supports this belief rather than considering an outfit that enhances your positive features and gives you a sense of femininity, glamour or sexiness.
Age can be noted in three ways, chronologically, physiologically and psychologically. Chronological age is the actual number of years that you have been alive, physiological age is the age of your organs and tissues and psychological age is your own perception of your age. The former is clearly unchangeable, however physiological and psychological ages vary according to our health. For example, smoking, drinking and a lack of exercise will have a detrimental effect upon our organs and tissues and hence the physiological ages of these structures. Interestingly, psychological age has an effect upon the physiology of the body as proven by a famous study completed in 1979. In placing individuals in a 1950s environment their measurable health parameters changed for the better, including eyesight. These individuals became ‘younger’ by manipulating the environment to alter their perception of the era.
So what does this mean? Essentially we can affect our health by feeling younger, changing our thought patterns and our beliefs. This is really very exciting as there are practical ways of becoming healthier and enjoying life to the full by changing our thinking and perception of ourselves. A makeover and styling session that optimises your look will have a significant impact upon your perception of who you are including how old you feel. Combining this with an exercise programme and healthy diet and you can really feel and look different. We know that exercise makes your brain fitter and more capable of concentrating, learning, remembering, reverses some of the effects of ageing by promoting the growth of new brain cells and improves mood. There’s no time like the present to ‘grow younger’.
See NHJ Style website: click here
Clinical Investigation of Pain-related Fear and Pain Catastrophizing for Patients With Low Back Pain
Check out this website I found at pdfs.journals.lww.com
Useful measures to identify factors that can affect outcomes: FABQ-PA & PCS
How injured nerves grow themselves back
via sciencedaily.com
Good new information about how injured nerves grow back, in particular identifying Schwann cell and fibroblast activity and inter-communication.
Monday, 27 September 2010
Pain Physio Tweeting
PAINPHYSIO ON TWITTER
Having dabbled lightly in social media, my interest in Twitter was first aroused by hearing Aggers and Bumble talk of ‘tweeting’ during a test match. Wondering what it was all about, I thought I would check out this phenomena and here we are some 450 tweets later. In fact, Twitter is a really good way of passing on information in a quick and ‘no-fuss’ way, either making a brief comment or linking to a page on the web. If you take a moment and click on link above you will be able to see that the vast proportion of the painphysio tweets relate to pain, science, health and medicine that is relevant to clients and health professionals.
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