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Care with labels: Psychosocial factors aren't a tick box exercise
Is it mood? Is it a pain âdriverâ? Is it neurodiversity? Is it burnout? Is it overwhelm? Is it demoralisation? With our increased understanding of pain has come a rise in screening tools, labels and ways of managing, especially in community clinical settings. Clinicians from a range of professional backgrounds are often involved in interpreting questionnaire results and having conversationsâŠ
When Everything Becomes an Outcome: Untangling the Confusion in Outcome Measurement
An outcome measure is a measure used to evaluate the results of an intervention â typically evaluating changes over time. But I hear the term used to refer variously to any assessment at any time, only questionnaire scores, only standardised assessments that result in numbers â so maybe itâs time to do some untangling. Outcome measurement and baking a cake An outcome is the result of something.âŠ
Do you need to be a psychologist to help people living with pain?
Iâm tempted to start with a TL;DR â and many of you will know exactly why. But some topics simply canât be reduced to a single declarative sentence, and this is one of them. Thereâs a persistent belief that pain is simple: fix the ânociâbioâ and the person returns to normal. Others argue that bringing in psychological aspects implies fragility, or that it means the pain must have aâŠ
Listen to the STORY
Have you ever read a clinical report about someone living with pain? It will probably include the age, gender, occupation, diagnosis, a brief history and a plan. But â where is the person? What does pain mean to them? Healthcare values objectivity. Objectivity is dispassionate, unbiased, impartial, based on fact not feelings. Roger Martin writes âThe dark shadow of the powerful light of scienceâŠ
Depression's quiet influence: What if pain rehabilitation means understanding mood too?
âWhen Cheree came for help with her low back pain, it wasnât hard to notice her low mood. It wasnât her tears, she didnât cry. It was her lack of energy, her low âget up and goâ, how slowly she replied to me, the difficulty she had telling me about her goals for the future. She wasnât seeing me for her depression. âBack painâ was written on her GPs referral. In fact, nothing in her notesâŠ
Person-centred or person-directed - Some thoughts
Person-centred: what do we mean by it? The WHO defines person-centredness as âHealthcare approaches and methods that consider the individual as a unified entity with multifaceted needs and objectives which stem from their unique social determinants of health.â Themelis and Tang (2023) consider it to be ârespectful of and responsive to individual patient preferences, needs, and values.â In 2001,âŠ
Autonomy not assumptions: The missing pieces in pain self-management
Clinicians carry clear ethical responsibilities: to benefit the person, to avoid or minimise harm, and to respect each personâs values and preferences (Singer et al., 2001). These responsibilities are reflected in the four foundational principles of health ethics:âą Beneficence â acting for the personâs benefitâą Nonmaleficence â avoiding harmâą Autonomy â supporting people to make their ownâŠ
The Emotional Dimensions of Pain Assessment
Take your mind back to your last pain assessment. I can bet good money pain intensity was measured (that 0 â 10 âhow much does it hurtâ question). Where it hurts on a body map. Perhaps even duration and constancy (intermittent, ongoing, fluctuating). Quality or âwhat does it feel like?â could be included: burning, aching, gripping, cramping, stabbingâŠ. All excellent things to know as clinicians,âŠ
Understanding Psychological Factors in Pain Management
Pain is defined by IASP (International Association for the Study of Pain) as âan unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.â There are notes accompanying this definition and you can see them here click. Last week I defined some terms often used in association with âpainâ â suffering, nociception,âŠ
The Complexity of Pain: Beyond Simple Words
OK Iâm a little pedantic at times, but hear me out! Words, how we use them and what we mean by them matter. They matter because distinctions help us stay focused on what we believe weâre actually helping people with. Pain: by now we should know that pain is defined by the International Association for the Study of Pain (IASP) as âAn unpleasant sensory and emotional experience associated with, orâŠ
What will 2026 bring? Reflections on Blogging in the Pain space
The start of a new year almost always brings reflections on the last 12 months. I often affirm what matters to me and think about how well Iâm living my values. I have no idea what this year will bring, and neither does anyone else. What I can do is set some intentions. So here goes. Someone said blogging is dead. That itâs not a thing any more. I disagree â the form of blogging has changed, butâŠ
Transformation: Paradigm shifts in pain therapy
Iâve sometimes felt like Iâm swimming against the current. Things I promote on this blog like âbiopsychosocialâ: mainstream in many parts of health today (see below) but operationally? Non-pharmacological approaches to pain: mentioned as a one liner in clinical updates âEncourage deep breathing or relaxation techniques, especially if light sedation is not used.â Rehabilitation programmes focusingâŠ
Luck, Fate, Personal Responsibility
For a moment, Iâd like you to stop and answer this question: âHow much do you think individuals are responsible for their health status?â If you can, give a number out of 10 where 0 = not at all responsible and 10 = fully 100% responsible. Hold that number in mind. I want to tell a story, itâs real. Iâd had widespread pain all my life, but was slim and fit: healthy. So when I became pregnantâŠ
Drowning in 'evidence'
A recent bibliometric review of journals with âpainâ in the title revealed 19 journals (Chi et al., 2025). There is no shortage of research being published in the area of pain â and not a gnatâs chance of keeping up with all the papers published. Papers arenât only published in these âpainâ-oriented journals, they can be in many other journals. And this raises some questions for me. EspeciallyâŠ
Do You Believe Me? Trust and the Politics of Pain in Clinical Practice
Trust. A term we use to mean our belief in the reliability or truth of someone or something. An attitude or belief that involves allowing ourselves to be vulnerable to another; an expectation that another will act in a certain way even though we canât be sure. Trustworthiness is the inherent quality of being reliable, honest, and worthy of trust. Trustworthiness refers to the characteristics orâŠ
Does accepting your pain mean you're giving up?
Acceptance and commitment therapy (ACT) for pain is sometimes seen as just about âgiving upâ on reducing pain. TL:DR ACT doesnât mean giving up How on earth can that be? Isnât it called ACT because itâs about âacceptanceâ? Letâs unpack âacceptance.â According to the Oxford Dictionary of Languages, acceptance means âthe action of consenting to receive or undertake something offered.â If I lookâŠ
Tailoring Pain Management: The Importance of Individual Concerns
Iâve been thinking about person-centredness and what this means in practice recently. Person-centred or patient-centred was first used by psychologist Carl Rogers in the 1970s, later aligned with a biopsychosocial approach espoused by psychiatrist George Engel. Two key ideas underpin person-centredness: (1) people should be seen not just in terms of their âpresenting problemsâ, but as wholeâŠ