David Evans

We discovered a new pain mechanism: Pain is facilitated between mirrored contralateral regions and inhibited between nonmirrored contralateral regions.

@GregLehman Crikey. I haven’t seen Janda come up in a discussion for years.

Just a reminder that the underpinnings of the Lower Crossed Syndrome were disproven 30 years ago and nothing has changed about this in 3 decades p.s. your Glutes are firing too jospt.org/doi/pdf/10.251…

@BillingMartin Nice technique! Mine was less tidy 😊

Just keeping in touch with these lifts nice to know still got 100 in the clean tank!

@DrJN_SportsMed @AdamMeakins This is of the same vain, but not as funny: Chronic widespread bodily pain is increased among individuals with history of fracture: findings from UK Biobank Karen Walker-Bone et al. Arch Osteoporos. 2016 pubmed.ncbi.nlm.nih.gov/26678491/

@AdamMeakins Hang on - I've only just noted the surname of the author - Washmuth?! Come on - did he use soap?? 😆

I’m really fucking happy to help get this paper published on patient centred swearing in physio! 🤭🫨😎 I hope it generates some fucking debate and gets some uptight physios to accept the diversity and variation in how we communicate with our wide and diverse patient populations! jhrehab.org/wp-content/upl…

@DrJN_SportsMed @AdamMeakins I was going to say something similar 🤣

Humans are wired to like low frequency light touch: youtube.com/shorts/RrfkCsl…

@PeteOSullivanPT Peter, that’s a dodgy review. It looks like the SMDs actually support passive over active. Plus there’s a retracted paper in there (Monticone). And they have included some sham treatments under passive: “Detuned US and detuned short-wave” and “Detuned pulsed ultrasound”. 💩💩💩

Research Tracking Change in Low Back Pain Practice Over 20 years | Health Sciences University hsu.ac.uk/research-track…

Your nose gets colder when you're stressed 👃 bbc.com/news/articles/…

@JArcher100 There were only a very few clinicians with dual qualifications. Removing these clinicians did not change the results

@drdavidevans Thank you for taking on this good research. Just two points from reading, the input from practitioners identifying across the professions, difficult for them to confirm exactly which one they represented? A high percentage of those who value massage, not just physio massage.

20 years in the making, just published today … I have to say, an important piece of work, especially if you are interested in back pain and it’s management: link.springer.com/article/10.118…

@JArcher100 Yes, massage was popular with all three professional groups, particularly in 2023. Physiotherapist showed the largest shift towards massage between 2003 and 2023, more than doubling their proportion.

@GregLehman @RogerKerry1 Interestingly, the term ‘passive’ was first applied in the 1990s to interventions for LBP, for which RCT evidence was not supportive, such as bedrest and ultrasound. Only later was the term applied to manual therapy interventions, but RCT evidence supported these, and still does

@RogerKerry1 @drdavidevans But passive interventions aren’t really that horrible. They don’t underperform active interventions as pretty much everything will “work” with acute LBP

An incredible piece of work from @drdavidevans and teams. Very disappointing to see that over 20 years, the direction that #Physiotherapy management of people with low back pain is increasingly towards nocebic messaging, passive interventions, and increasingly away from evidence

@RogerKerry1 @drdavidevans Mind boggling...

Should of interest, @RogerKerry1 , @DerekGriffin86 , @MM_Physio , @adamdobson123 , @MattLowPT , and @JackAChew got an acknowledgment helping to distribute the 2023 invitation 😊

@AsafKlaf You make a good point here. Is there an established clinical correlate for what is commonly attributed to CS? I guess tenderness would be part of this? But there is not really a ‘tissue sensitivity’ descriptive term.

According to Betteridge's law of headlines, the answer is - NO. This review adds nothing new. Central sensitization with regard to #ChronicPain in humans remains theoretical and possible but unproven. And if it is indeed a mechanism for persistent pain, it is only one mechanism out many other potential mechanisms of nociceptive dysfunctions. sciencedirect.com/science/articl… #pain

A wonderful reminder of the importance of genetic science for real clinical conditions bbc.co.uk/news/articles/…

🙏🏻 Finally after 3 years of work. A complete refutation of the popular aphorism “nociception is neither necessary nor sufficient for pain”. This one was rejected faster than light speed but all the major pain journals but was finally accepted by BRAIN which has more than double the impact factor of PAIN which is the no.1 pain journal.

@AsafKlaf Looking forward to reading this

@drdavidevans et al. find that symmetrical (mirrored) bilateral limb pain is more prevalent than previously thought. Pain is facilitated between mirrored contralateral regions and inhibited between nonmirrored contralateral regions. Learn more in #PAIN bit.ly/46N1t62

September is Pain Awareness Month. We’ll be highlighting content from #PAIN related to weekly themes—stay tuned as we share more throughout the month. #PainAwarenessMonth