​In 2020, the world was battling COVID-19 and many countries introduced lockdowns or restrictive measures. Three years later, such lockdowns and restrictive measures are luckily not required anymore to protect us from COVID-19, but did you know that millions of people (65 – 144 million) are still living in lockdown or under restrictive measures as a result of their COVID-19 infection? These people suffer from long COVID.
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Several chronic musculoskeletal conditions are characterized by pain and changes in connective tissue. Treatment has traditionally focused on regional processes. Frequently, it is thought the injuries arise from a local origin. Herein, local inflammation initiates mechanisms to drive adaptation and repair.
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Acute pain is “a normal, predicted physiological response and experience to a noxious chemical, thermal or mechanical stimulus associated with acute illness, trauma or surgery”.1,2 Acute pain is usually sudden in onset, limited in time, and motivates behavioral responses to avoid actual or potential tissue damage.
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Chronic pain is defined as pain that persists for more than three months and currently affects over 20% of people worldwide, making it the leading cause of disability and disease. Despite its prevalence, optimal treatment for chronic pain is still lacking.
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Although there are more cancer survivors due to better treatment options, cancer survivors still face many challenges including chronic pain1,2. According to recent studies, approximately 40% of cancer survivors suffer from chronic pain which significantly impacts their quality of life1,3,4. Nowadays, scientists are investigating the underlying mechanisms so they can better understand the causes of chronic pain in order to improve pain management.
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Pain catastrophizing: as a clinician and/or researcher in the field of pain, this term may sound familiar to you. Pain catastrophizing is often broadly conceived as an exaggerated mental mindset during painful experiences (1). It has been identified as an important and consistent psychosocial predictor of almost every significant pain-related outcome.
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It is that time of the year again… The leaves have fallen from the trees, days are short, and the weather outside is freezing cold. While we are spending our time sitting on the couch under a nice warm blanket, we daydream about sunny beaches, summer bars, and flip flops. Typically during winter, we have the feeling that our neck or low back is hurting more. Our joints are feeling stiff and we have less motivation to exercise. Health professionals experience that their patients with chronic musculoskeletal pain are feeling worse during bad weather. But is this only a feeling? Or does the weather actually influence our pain experiences?
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Just published in Physical Therapy in November 2022 is a proposed new model for addressing the problem of chronic low back pain (CLBP) in physiotherapy: The Fit-for-Purpose model (Wand et al., 2022).
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Illness perceptions - or in our case injury perceptions - are defined as organized representations patients have about their condition (injury). Health threats may elicit these cognitive and emotional representations and further influence a patient’s behavior. Cognitive representations are central mechanisms to control danger and emotional representations are central mechanisms to control fear. If the central neural system (CNS) decides a person is in danger, pain may be processed. Pain is a neurophysiological phenomenon and one of the most powerful and sophisticated constructs from the human’s sensitive CNS to protect us from danger.
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The COVID-19 pandemic, decreed by the World Health Organisation on 11th March 2020, has had a dramatic impact on the health of the population, especially the elderly people. Lockdowns and mobility restrictions became a necessary measure to stop the spread of the virus and resulted in a drastic sudden change in everyone’s lifestyle and a great influence on the diet, exercise, social activities, and mental health.
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Guidelines on pain management for patients with chronic pain all promote physical activity and exercise as part of treatment strategies. However, chronic pain is a very broad term and it encompasses many different populations. Each individual will have a different experience of their pain and will have different influencing factors.
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The internet presents much health information that is available to anyone with easy access. It has become the primary source for patients and families to find information about their clinical condition including symptoms, preventive methods and treatment options [1].
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Chronic musculoskeletal pain is one of the most common chronic pain conditions and can be described as pain arising from muscles, tendons, joints and ligaments, which has been present for at least three months [1, 2]. Chronic spinal pain (CSP) is the most frequent form of chronic musculoskeletal pain and is situated in the cervical, thoracic or lumbar region [3-8].
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Distinguishing normal from abnormal when interpreting brain scans can be challenging, especially as a novice. One of the patterns you might notice is that certain brains have enlarged perivascular spaces. These spaces, also referred to as “Virchow-Robin” spaces, are generally considered normal.
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Pain is one of the most disabling and occurring symptoms in cancer survivors (1). About 5-10% of people surviving cancer develop chronic severe pain, which is up to 40% in the early post-treatment period of cancer (2). Up to now, pain medication is still the recommended standard treatment for cancer-related pain (3).
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For many children, needle procedures can be a painful and distressing experience. Such negative experiences can further develop into fear of needles (McMurtry et al., 2015) with a possibility of adverse consequences, such as health care avoidance behavior and vaccine hesitancy. Given the current combat with the COVID-19 pandemic and global vaccination campaign, which since recently also includes children, reducing fear of needles is important to consider and manage (Love and Love, 2021).
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Chronic pain, chronic primary pain, chronic secondary musculoskeletal pain, chronic postsurgical or posttraumatic pain,… What is the difference between these terms and which one contains knee osteoarthritis pain?
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There is something tempting about numbers and figures. They are ‘clear’, we believe them to be straightforward and helpful in untangling our complex world. In healthcare, both clinical and in research, we love quantitative measures.
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Haemophilia is a genetic disorder which is characterized by recurrent joint bleedings. Consequently, the majority of adult PwH suffer from very painful and invalidating hemophilic arthropathy. Although the complexity of joint pain has been studied in several chronic joint pain conditions, until present only very limited research has been done on joint pain within PwH. As a result, developing effective treatments for chronic pain in PwH has been clearly identified as a priority for research in bleeding disorders.
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It is a challenging time to stay active and to adapt our normal activities due to the COVID-19 pandemic. As working out in group or with a supervisor is not always possible, exercises at home gain popularity. We have never been walking so much as during the past year, as it was one of the only possibilities to have some social contact.
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Every time we experience something new, we are in the position of learning and memorising the new experience. Learning depends on several factors, including motivation, rewards, self-reflection, saliency, and repetition. One additional important aspect that seems crucial for learning is the presence of a prediction error.
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Over the past decades mechanism-based approach to pain management has been progressively underlined to achieve clinically meaningful improvements in pain outcomes.
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COVID-19, a highly infectious disease that was first reported in Wuhan in China in December 2019, has definitely changed our behaviour. COVID-19 is caused by the SARS-CoV-2 virus.
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Overwhelming evidence proves the notion that reduction in daily physical activity is a risk factor behind several chronic diseases (Lacombe et al., 2019) and that individuals who are more physically active have a lower risk for the development of chronic pain (Landmark et al., 2011).
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​To date thousands of rare diseases have been described in medical literature and still every day researchers worldwide are working to discover and better understand new unique diseases.
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​“Can you have a look at my back when you visit us tomorrow?” A friend sends me a text on Saturday. My phone rings, it’s my mother calling: “My ankle hurts. I am already unable to walk normally for the whole week now. What do you think it is?”
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Pain Neuroscience Education (PNE) is a method of educating patients about the neurophysiology of pain. It aims to re-conceptualize pain from an indicator of damage to an interpretation of input signals by the brain and nervous system.
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n the acute phase after whiplash injury, most patients report pain and disability. Usually, these complaints reduce gradually within the first three months (1). Some patients continue to experience pain and disability and develop chronic Whiplash Associated Disorders (WAD).
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It is important to increase our understanding of the mechanisms underlying the transition from acute to chronic non-specific low back pain (NSLBP) to improve treatments for NSLBP and individual treatment decisions in an early phase of low back pain and ultimately to prevent the development of chronic NSLBP.
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Non-specific musculoskeletal pain is highly prevalent, with point estimations up to 51% in Europe1,2. Percentages are higher in women than in men3 and most commonly represent pain in the lower back, shoulder, neck, hip or knee.
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Following new approaches to chronic pain management, mechanism-based therapy is considered more effective than diagnosis-based treatment (Levin, 2004, Nijs et al., 2019a). Pain phenotyping is a challenging issue that seems to contribute to the provision of individualized rehabilitation and patient-centered care (Nijs et al., 2021).
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COVID-19, a highly infectious disease that was first reported in Wuhan in China in December 2019, has definitely changed our behaviour. COVID-19 is caused by the SARS-CoV-2 virus. The World Health Organisation has declared COVID-19 as a pandemic on March 11th, 2020 due to the rapid increase in number of confirmed cases (Wang et al. 2020).
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The International Association for the Study of Pain (IASP) defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (1). Pain is considered as a warning system for tissue damage.
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There is no doubt that musculoskeletal pain is a complex multidimensional phenomenon. At present, musculoskeletal pain diagnosis is based primarily on signs and symptoms, sometimes combined with evidence of disease, structural damage, or injury.
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Can we train the chemo-brain?   September 23rd, 2020
“When I meet a friend on the street, I can’t even remember her name.”
 “Where did I leave my keys?”
 “Oh, darn I forgot my doctor’s appointment today!”
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At the start of this research series, we were asking the clinical question as to why central sensitisation (CS) develops in some people and not in others. Is it something to do with their personal characteristics of sensitivity? Here, I want to outline what we did to begin investigating this and summarise for you the proposals we came up with.
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Despite the long history of usage in medicine, psychology, sociology and other sciences, the terms “moderator”, “mediator”, “predictor” and “prognostic factor” still seem to elicit discussions among researchers. Several authors have described how these terms are used interchangeably, neglecting important careful handling
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For many patients, ongoing or recurrent pain severely impacts their physical, social and mental health, as it interrupts ongoing activities and thereby continuously interferes with daily life functioning.
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The World Congress on Pain 2018, organized by the International Association for the Study of Pain (IASP) was held in Boston, Massachusetts, USA. This meeting focused on sharing new developments in pain research, treatment, and education.
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Sleep regulation: an important issue?   November 29th, 2018
Sleep problems are frequently seen in several chronic pain populations.
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The scientific committee is proud to announce the program for the Pain, Mind & Movement ‘Applying Science to the Clinic’ Satellite Meeting of the 17th World Congress on Pain.
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The scientific committee of the Pain, Mind & Movement: Applying Science to the Clinic satellite meeting welcomes submissions for oral presentations and clinical workshops.
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For centuries chronic pain has been viewed as a solely biomedical issue in the tissues. However, times are changing and we now know that (chronic) pain is a complex construct in which not only physiological factors play a role. In addition, pain is influenced by psychological factors, such as thoughts and feelings, and social factors, for instance judgement and misunderstanding.
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The biomedical model falls short in explaining chronic pain. Although many clinicians have moved on in their thinking and apply a broad biopsychosocial view with regard to chronic pain (patients), the majority of clinicians (including myself) have received a biomedical-focused (undergraduate) training/education.
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It is well established that pain has the function of maintaining the integrity of the body. Pain is an evolutionarily acquired alarm signal of bodily threat and this phylogenetic function is extremely important for survival.
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Lage rugpijn blijft één van de duurste en meest invaliderende problemen van onze Westerse samenleving. Logisch dus dat voor vele stakeholders (patiënten, paramedici, artsen, firma’s en overheden) de focus hierop ligt.
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Jaarlijks worden enkele duizenden patiënten geopereerd voor lage rugpijn met uitstraling naar het been (lumbale radiculopathie). Onderzoek wijst uit dat 23-28% postoperatief chronische pijn zullen ontwikkelen.
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