Chronic pain is debilitating to individuals and to our economy, yet most treatments are based on the assumption that it is due to a physical cause. Once it is recognised that chronic pain is caused by our brain and central nervous system as part of a protective stress-processing response, then as this process is reversible, full recovery is possible.
SIRPA Ltd was set up to train health professionals to integrate into their own work the pioneering SIRPA approach, where the emphasis is on recovering from chronic pain, rather than management.
www.sirpauk.com
Building your back ultimate remedy from lower backpainsundeepchhabra1
For the 16 million Americans liaving with chronic back pain, symptoms can impact every part of life – especially at work. Back pain in the workplace is the leading cause of disability worldwide. Even for those whose jobs don’t include any manual labor, pain can still be debilitating.
Pain that quickly resolves can be distracting enough. When pain lasts for more than three months, it becomes chronic. Chronic pain can have serious consequences for work performance, sleep quality, and even interpersonal relationships.
Building your back ultimate remedy from lower backpainsundeepchhabra1
For the 16 million Americans liaving with chronic back pain, symptoms can impact every part of life – especially at work. Back pain in the workplace is the leading cause of disability worldwide. Even for those whose jobs don’t include any manual labor, pain can still be debilitating.
Pain that quickly resolves can be distracting enough. When pain lasts for more than three months, it becomes chronic. Chronic pain can have serious consequences for work performance, sleep quality, and even interpersonal relationships.
Pain and Opioids: damage and danger, mechanism and meaningMark Sullivan
In this presentation, I argue that pain exists more to protect than to inform, so survival implications affect pain processing. The salience and valence of pain are continually adjusted to promote survival. For humans, physical survival depends on social survival, so our brains have evolved to make both physical and social injury painful, with our endogenous opioid system modulating both forms of pain to promote both forms of survival.
DR SANJAY PHADKE- Introducing Symposium on MIND- BODY MEDICINEDR VANI KULHALLI
The critical importance of mind body medicine as regards
- treatment gap of 80-96pc for mental illness
- proved benefit
- can be administered by non medical professionals
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Understanding Opioid Dependence: a significant harm of long-term opioid therapyMark Sullivan
In this presentation, I argue that prescription opioid policy is often framed as a balance of the right to pain relief vs the risk of addiction. But our brains have evolved to make both physical and social injury painful, with our endogenous opioid system modulating both forms of pain to promote both forms of survival. Long-term exogenous opioid medications disrupt this system and thereby impair human social and emotional function.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
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Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
3. Learning Objectives
To understand:
•The concept of stress-induced chronic pain
•How SIRPA’s approach can help patients suffering
from chronic pain recover based on this understanding
3
4. Hippocrates
“It is more important
to know what sort
of person has
the disease than
the disease the
person has”
460 BC – c. 370 BC
4
5. New interventions for LBP needed
European Spine Journal : Review article
Volume 16, Number 11 / November, 2007 Pages 1776-1788
‘Effect sizes of non-surgical treatments on
non-specific low-back pain’
Conclusions: ‘The effect of treatments for LBP is only small to
moderate. Therefore, there is a dire need for developing more
effective interventions.’
7. Anomalies
7
• Symptoms often don’t match the diagnosis
• The onset of pain is often after doing
something completely innocuous or
something the patient normally does with
no problem
• The onset of pain can often not be linked
to any physical incident e.g. they wake up
with it.
• People with postural, structural or
biomechanical ‘abnormalities’ often
recover, despite these remaining
unaltered
• Chronic pain is often non-specific and
medically unexplained.
8. 79 year old lady with 4 week h/o severe back
pain and bilateral leg pain with numbness,
resulting in her inability to walk unaided
“Widespread degeneration
throughout the lumbar
spine with almost total
effacement of the
epidural and CSF signals
at the L4/5 level,
confirming subtotal
spinal block”
8
9. 79 year old lady with 4 week h/o severe back
pain and bilateral leg pain with numbness,
resulting in her inability to walk unaided
Questions to consider:
•Why had she only had pain for 4 weeks, yet
this sort of spinal degeneration takes
decades to develop?
•How was she able to recover fully within 6
weeks with very gentle treatment, despite
her spinal degeneration remaining
unaltered, such as the stenosis?
•Why was she able to remain pain free if the
spinal degeneration was the cause of her
symptoms? - see later
12. Research into MRI scans of
people without back pain
1) The Journal of Bone and Joint Surgery, Vol 72, Issue 3
403-408, 1990 SD Boden et al
Conclusions: About one-third of the subjects were found to have
a substantialabnormality (57% in the over 60s)
2)New England Journal of Medicine: Vol 331; 69 – 73, July 14th
1994, No. 2 Maureen C Jensen et al
Conclusions: The discovery by MRI of bulges or protrusions in
people withlow back pain may frequently be coincidental
12
13. Research into MRI
scans of the spine (2)
3) Ann Rheum Dis. Vol. 62: 371-372 (2003 ) Centeno and
Fleishman ‘Degenerative disc disease and pre-existing spinal pain’
Conclusion: “Degenerative disc disease, as seen on imaging, is not
a painfulcondition.”
4) The Journal of Bone and Joint Surgery (American)
83:1306-1311 (2001) David G. Borenstein et al
The Value of MRI of the Lumbar Spine to Predict Low-Back Pain in
Asymptomatic Subjects’ A Seven-Year Follow-up Study
Conclusions: The findings on magnetic resonance scans were not
predictive of the development or duration of low-back pain.
14. Pain versus
Posture/Structure/Biomechanics
The fall of the postural–structural–biomechanical
model in manual and physical therapies: Exemplified
by lower back pain
Findings – There is no correlation between pain and
posture, structure or biomechanics of the spine.
by Eyal Lederman
CPDO Online Journal (2010), March, p1-14. www.cpdo.net
14
16. Back pain and RSI
The number of people developing Back pain
and RSI continues to rise, despite the
introduction of these national regulations in the
early 1990’s. These regulations are addressing
the widespread current belief that there is a
physical cause for these conditions.
But what if they aren’t physically induced?
16
17. Work environment
and back pain
Work and back pain: a prospective study of
psychological, social and mechanical predictors of
back pain severity. Christensen J O et al.
Eur J Pain. 2012 Jul;16(6):921-33
Conclusions: The most consistent predictors of back
pain prevention were found to be decision control,
empowering leadership and fair leadership
18. The role of physical and
psychological factors in
occupational low back pain
Occup Environ Med 2000; 57: 116 – 120 (February) Anne-
Marie Feyeret al New Zealand 1999
Conclusions: Other than a history of LBP, pre-existing
psychological distress was the only factor found to have a pre-
existing influenceon new episodes of LBP
N.B. This could have included stressors such as; exam worries,
relationship issues etc
19. • ‘No stress, No whiplash’ (Castro et al., 2001) and demolition
derby drivers have less chronic neck pain (Simotas & Shen,
2005)
• Hauser et al. (2011) report there is a significant association
between sexual and physical abuse in childhood and
fibromyalgia. Work place bullying was also found to increase
the incidence of newly diagnosed fibromyalgia (Kivimaki et al.,
2004)
• Higher percentage of back pain in adolescents with mental
health problems (Rees et al., 2011)
Evidence linking
stress to pain
19
20. Emotional & physical pain
• Physical and emotional pain have been shown to
trigger the same areas of the brain
Kross et al. ‘Social rejection shares somatosensory representations with physical pain’.
Proceedings of the National Academy of Sciences in the USA. 2003, 23: 15280 – 15283
• The emotional brain is activated by fear and worry,
which cause pain pathways to become more
pronounced
Bailey et al. ‘Treatments addressing pain-related fear and anxiety in patients with chronic
musculoskeletal pain: A preliminary review’. Cognitive Behaviour Therapy. 2009, epub.
August 20, 2009
Asmundson G et all. ‘Understanding co-occurrence of anxiety disorders and chronic pain: State
of the art.’ Depression and Anxiety. 2009, 26: 888-901
20
21. The concept underlying
the SIRPA approach
• Physical and/or psychological symptoms
become the escape mechanism for
unresolved emotions when they build up
and for which there is no other outlet.
• The symptoms are part of a protective,
stress-processing response, which is
automatic and unconscious.
21
22. • Current Life stresses/responsibilities
• Childhood, or past, ‘traumas’ or pressures
• Self-induced pressures due to; personality traits,
learned behaviours & beliefs e.g. being overly analytical
or self critical, the need to please/be good/perfect etc,
and/or the belief that they have a ‘weak/damaged’
back/neck/shoulder etc
• Being constantly on the go, overstimulation, overwhelm
& lack of time to ‘defuse’
Underlying causes of
psychophysiological symptoms
22
23. Are you saying the pain
is all in the head?
Symptoms are a result of unconscious and automatic
responses in the brain and central nervous system when the
emotional brain has been triggered.
NO!
24. Emotion
Neuropeptides (molecules of emotion) flood the body and brain
Stimulate the emotional brain e.g. the Amygdala
The Hypothalamus triggers physiological changes via the
Autonomic Nervous System (ANS)
Basic Neurophysiology
24
25. The ‘fight and flight’
response is a
survival/protective
response to a
perceived ‘threat’.
Physiological changes
occur via the ANS –
and is automatic and
unconscious.
The Stress Response
25
26. Modern stress/threats
Are mainly psychological
However………….
Our perceived stress is only 10% due to what happens to us
(physical or psychological) and 90% how we deal with it.
i.e. psychological - self-induced stress
e.g. ruminating over things or over-analysing. Being self
critical, a perfectionist, a people-pleaser, a ‘coper’,
conscientious etc
27. 79 year old lady with 4 week
h/o severe back pain & bilateral
leg pain with numbness
27
If you remember this lady, her pain came on just before her
daughter left for a month’s holiday in Australia.
For an elderly person this was a huge stress. She was fearful
of being on her own and also having strangers (Home Care
staff) coming into her home each day, but she bottled up
how she felt because she didn’t want her daughter to worry
about her.
The symptoms were protecting her from falling apart emotionally and/or
having to deal with these ‘dangerous’ emotions.
She recovered after offloading her fears , getting used to the new staff and
then as she was improving, her daughter returned home. There was no further
need for her symptoms to ‘protect her’.
28. Symptoms protect
A GP had been unable to write for
months. During an in-depth
assessment it turned out he had not been
able to write since he collapsed (while
writing) and had to have life-saving heart
surgery
N.B. He could type all day and had no
other problems with his hand at all.
His brain had associated his nearly dying with writing, so the unconscious ‘stress
response’ would cause his hand to “go dead” to protect him from this ‘life-
threatening’ activity. Recovery was swift with simple, self-empowering
strategies.
28
29. Case study: 6 month
exacerbation of chronic LBP
MRI results: ‘massive disc protrusion at L5/S1, compressing both
S1 nerve roots and causing marked central canal stenosis’. (see
slide 11)
Symptoms: bilateral constant sciatica, pain was scored from 6 –
10, (with 10 the maximum) plus numbness laterally over both
ankles and feet.
Signs: Reduced Lx ROM, loss of bilateral ankle reflexes and
minimal strength in left plantar flexors.
Pain Medication: Gabapentin, Dihydrocodeine, Diclofenac,
Paracetamol 29
30. A&E with
intravenous opioids
This lady’s nerve pain
pathways had become learned
and during the previous 6
months she had been unable
to sleep for more than 20
minutes at a time.
The following slide shows a
graph she completed herself
during her recovery while
following the SIRPA Recovery
Programme.
30
32. 3 years later
Still fit and healthy 3
years later and
bouncing on a
trampoline.
32
33. No exercise, drugs, hands on therapy or surgery
The symptoms are a result of physiological changes in
the body and as the process is reversible, full
recovery is possible.
Identification of links and triggers for the symptoms
can significantly help a patient progress.
N.B. Patients can follow the programme independently, with the support of a therapist, or as part
of a group (where available)
The SIRPA Recovery Programme
33
34. Cautions
• Any more serious cause of the symptoms need to be
ruled out, such as; cancer, infection, fracture or an
auto-immune disease
• People with unstable or severe mental health
conditions are advised not to follow the programme
unless supervised by a trained mental health therapist
34
35. • Accepting that the symptoms are stress-induced and not due to
a physical cause is important for a full recovery. N.B.
Sometimes having a diagnosis by a SIRPA Practitioner can help
with this.
• Acknowledging the underlying causes of the pain is important
where the aim is recovery rather than management and can
often be done simply by therapeutic journaling
• Strategies can then be learned to help patients reduce the
causes of self-induced stress as a result of their personality
traits, learned behaviours etc.
The SIRPA ™ approach
35
36. Treatment progression
Educational, self-empowering
and very often can be self-directed
In-depth SIRPA™ Assessment
(a Stress check-up to help identify links and triggers for their pain)
Follow the online programme
alone or with professional support
(or as part of a SIRPA Recovery Programme for groups)
Further support and/or refer on
(Other self-empowering approach or Psychotherapy )
Books, CDs, online SIRPA
Recovery Programme
With a SIRPA
Practitioner
Support can
be face to
face or via
skype
36
37. • Therapeutic journaling – to identify, acknowledge and
gain perspective in order to let go and move on
• Mindfulness and Mindfulness Meditation
• Supportive self-talk
• Visualisation
• Some cognitive behavioural tools
Some strategies included in
the SIRPA Recovery Programme™
37
38. Some evidence for a few of the
treatment strategies used
• Mindfulness meditation reduces
stress and amygdala activation
(Holzel et al., 2010)
• Experience in meditation
predicts a less negative appraisal
of pain (Brown & Jones, 2010)
• Journaling or private emotional
disclosure reduced pain in
people with fibromyalgia (Gillis
et al., 2006)
38
Not here to convince, can’t convince how long standing or severe is not usually an issue
To demonstrate how even very real physical ‘abnormalities’ are usually not the cause of pain
To demonstrate how even very real physical ‘abnormalities’ are usually not the cause of pain
We all expect someone with a knee like this on the left to have pain, yet some don’t – why? Yet often people present with no abnormality, nor any injury and yet have pain. Studies now show that the brain can create pain, without there having been any physical trauma.
Yet often people present with no abnormality, nor any injury and yet have pain. Studies now show that the brain can create pain, without there having been any physical trauma. Normal activities resulting in pain, waking up, no cause etc
More recent
Physiotherapist - transition was gradual Slipped discs –anomalies between nerve ‘compressed’ and symptoms, stenosis – cancelled surgery Minor incident causing back pain e.g. picking up a pen, waking up with pain, chronic pain no diagnosis. RSI – same work for years, yet suddenly begin with pain. display screen equipment regs and often no signs apart from pain
Norway Occy Health study Taking responsibility, feeling self-empowered.
- Castro et al tested 51 people in a low velocity rear end collision. They asked subjects to fill out a questionairre prioir to the collision, immediately after, 3 days after and 4 weeks post collision. They used the Freiburger Personality Inventory, as psycho-analysis. They found that subjects who score high on pain immediately after and three days after scored higher on the psychosomatic disorder and emotional instability. - Simotas & Shen questioned 40 demolition derby drivers, who were involved in 30 career events, with a total of 52 rear end collisions during each event. Only two of the drivers reported their post participation neck pain lasted more than 3 months. In a population it has been reported to be as 14-40% who report chronic whiplash. They suggest it may be motivational differences between demolition drivers and normals that cause this. Hauser et al performed a meta analysis of 18 studies and found that there was a significant association between physical and sexual abuse in childhood and adulthood and developing fibromyalgia later in life. - Kivimaki et al conducted a prospective study of 4791 individuals, 90% female, who had no diagnosis of fibromyalgia at the outset. They were asked to fill out a survey at the outset and 2 years later. 81% of the people responded, workplace bullying had the strongest association with fibromyalgia, followed by high workload. - Rees et al also conducted a prospective study of 1580 individuals, who provided information on spinal pain and child behaviour checklists. They found a significant association between mental health problems and spinal pain. The strongest link was found in those that internalise and externalise through unsociable behaviours.
Symptom less important than the underlying cause.
10%/90% Could be minor trigger – e.g. angry boss, anniversary, causing emotional trigger
Primal response. These days more psychological threats. Protect us – explain. Waking the Tiger example – gazelle/lion
What health professionals say and google plays a big part in whether someone gets worse or better afterwards
Holzel et al examined 26 individuals who were stressed on a perceived stress rating scale but otherwise healthy, before and after an 8 week mindfullness meditation programme. There was a decrease in perceived stress and a reduction in amygdala activity compared to pre programme MRIs. Brown & Jones found that people with experience in meditation reported less unpleasantness to laser heat stimulus compared to controls. They were asked to report this during the laser stimulus. People did various different types of meditation. Gillis et al found that private emotional disclosure lead to a decrease in pain after 3 months compared to writing about time management.