A few days ago, a woman posted a message on to a local community Facebook page asking for the following advice; Has anyone had any experience with sciatica nerve pain and useful treatment? Hubby has been in terrible pain for weeks now. Thanks for any thoughts or recommendations. The advice that followed all came from local people and probably represented a fair snapshot of what many people currently think about the management of back pain. I've printed the whole exchange below - it's long enough to be inclusive, but not too long - so that you can draw your own conclusions, but here are a few thoughts that occurred to me reading through it.* All posts bar one were from women. There … [Read more...] about Evidence-based practice will not help us now
One of the biggest dilemmas facing the physiotherapy profession today is how to keep it alive. Given the unrelenting pressures to reform, cut costs, and redesign practice, it's hard to know whether to push the profession's stability, history and established culture, or to promote a radical new professional image. And faced with healthcare innovations that seem to be dissolving old certainties, it's hard to know whether we like it or not. Imagine, for instance, that robots were shown to be more reliable manipulators than physios, or that a low-cost assistant could do the work of post-op respiratory physiotherapy just as well as an expensively trained clinician. Would we promote … [Read more...] about Should we give up physiotherapy?
Perhaps one of the biggest points of difference in current debates around the future of physiotherapy involves the question of whether physiotherapy should be evidence-based. It is self-evidence - so some say - that physiotherapy practice should be based on the best available evidence, since to practice otherwise might put people at risk, or damage the reputation of physiotherapy as a science. One of the less-well-often discussed issues with this argument is how much people - and by this I mean the public, our professional colleagues and peers, and the organisations that fund us and legislate for us - actually care whether some therapeutic practices are evidence-based. An article … [Read more...] about The politics of touch
There's been a recurring theme in many of my blogposts this year, and a Facebook post by Adam Meakins on Wednesday summed it up beautifully. In the post (here), Adam was responding to an earlier post by Brent Brookbush promoting a new educational video of a muscle tissue release technique, to which Adam made this comment; The continued illusion or delusion of therapists thinking they can find 'nodules' 'trigger points' 'knots' 'taut bands' 'scar tissue' ''gristly bits' 'snotty shit' 'gammy areas' still astounds me in 2016... these are just soft tissue sore spots of an unknown origin... Meakins (2015) http://bjsm.bmj.com/content/49/6/348.full.pdf The issue that I've been grappling with … [Read more...] about Sore spots
Like most people, I'm still feeling the shock of Donald Trump's US presidential election win last week. Once all the dust has settled, and people have started to face up to what has been called the 'post-truth' era in politics (see this or this), there will have to be some real soul searching about what this all means for the future of our societies. Big issues like environmental degradation, personal security, tolerance for others, and health, will play out alongside more 'local' issues like paying the weekly bills, dealing with family problems, and managing our busy lives. Amidst all this 'noise' its worth reflecting on something subtle but highly significant about this recent … [Read more...] about Trump, Brexit and physiotherapy
In this final 30DoS for 2016, Director of Professional Policy at WCPT - Tracy Bury - writes about the seminal work of David Sackett and how it influenced her critical thinking. The publication of Evidence based medicine: what it is and what it isn’t (Sackett et al) in 1996 was the culmination of a growing discourse on the challenges of integrating research evidence with clinical expertise for the benefit of patients. The authors also referenced EBM’s philosophical origins in mid-19th century Paris whilst describing it as a young discipline. The definition for EBM that was set out is now universally recognised. The importance of clinical experience, competency and judgement were … [Read more...] about Tracy Bury – EBM: What it is and what it isn’t – 30DoS #30
In this post, CPN member Carley King writes about Ian Leslie's article The Sugar Conspiracy. This “long read” article from the Guardian outlines how in 1972, John Yudkin raised concerns about sugar being the greatest danger to our health instead of fat. However, his research findings were ridiculed, and fat continued to be labelled as the likely cause of obesity and the numerous conditions associated with obesity. It outlines how the scientific community embraced a certain school of thought and disregarded any subsequent evidence that suggested otherwise, i.e. saturated fats are particularly bad for your health. It suggests that this tide of movement was predominantly driven by … [Read more...] about Carley King – The sugar conspiracy – 30DoS #18