The Conversation: Success in treating persistent pain now offers hope for those with Long COVID

SNT Gatchaman

SNT Gatchaman

Senior Member (Voting Rights)
Staff member
Not a recommendation, with a giveaway being the use of "CFS/ME"

https://theconversation.com/success...-offers-hope-for-those-with-long-covid-232897

---

Hamish Wilson
Associate Professor in General Practice, University of Otago

John Douglas Dunbar
Clinical Senior Lecturer in Surgical Science, University of Otago

Persistent pain often arises from a hyper-vigilant nervous system which perpetuates the warning signal. The underlying neurophysiology in persistent pain is known as “central sensitisation”. This term describes an overly sensitive warning system causing exaggerated pain signals even after damaged tissue has healed.

Central sensitisation depends on the phenomenon of neuroplasticity. Neurological pathways we use frequently become more established, efficient and dominant. In persisting pain and fatigue, the associated neural pathways become highly developed, even if this is counterproductive to normal functioning.

While neuroplasticity contributes to the development of unhelpful neurological pathways, the converse applies, too. Unhelpful pathways can be down regulated, improving symptoms.
Click to expand...

Research shows promising early results. One study addressed subconsciously held beliefs about the nature of the illness, which reduced the fatigue of Long COVID, with sustained effects at six months.
Click to expand...

A Scandinavian research group has also questioned current narratives describing persistent fatigue syndrome as an “incomprehensible and incurable disease without any available treatment”. Instead, they called for a more constructive narrative based on emerging insights about the nervous system and its role in creating, and at times inadvertently perpetuating, the debilitating sensation of fatigue.
Click to expand...

Referencing the Oslo Consortium: Chronic fatigue syndromes: real illnesses that people can recover from (2023, Scandinavian Journal of Primary Health Care)

These insights may allay current fears about Long COVID as a mysterious illness. While there is no magic bullet, supportive care supplemented with “fatigue neuroscience education” may provide patients with a better understanding of the mechanisms behind their symptoms and useful advice for recovery.

These concepts have yet to be integrated into medical training and clinical care for persisting fatigue syndromes. But ongoing neuroscience research and reports of encouraging clinical results now create some optimism for understanding and treating Long COVID.
Click to expand...
 
I have read this article multiple times now and have finally realised why something felt “off” about it, aside from the theme. I have a nagging feeling that the article was not entirely the work of the authors. It is too slick and specific to the BPS (Oslo consortium) dogma, with links to papers that would be obscure to anyone outside of that clique. It lacks any specific context to NZ or links to any local studies.

Is it possible that the Oslo consortium spin doctors wrote this with the intention of Wilson & Dunbar putting their names to it? Or at least spoon-fed them the key points and links?

It would be interesting to compare and contrast with other recent or future articles on this theme in other parts of the world.
 
Art Vandelay said:
It's interesting that the Conversation isn't allowing comments on this article. Some have left critical comments on the associated Facebook post instead:
Click to expand...

I read the little bit of text at the top of that Facebook post (I don't have a Twitter account so can read very little on there these days.)

Chronic pain is often caused by a hyper-vigilant nervous system which exaggerates the pain signal even after damaged tissue has healed. Similar processes are at play in persistent fatigue.
Click to expand...

There is an assumption, both in medicine and society in general, that when an injury of any kind has healed that the healed tissue works exactly the same as it did before it was damaged. People accept that external damage might leave scars, but they are assumed to be unimportant once the healing is complete. Internal damage (e.g. adhesions) is usually assumed to not even exist because it can't be seen and doesn't show up in scans.

A common example - any woman who has had gynaecological surgery of any kind is assumed to be fine within a few short weeks of the surgery being over. The fact that adhesions after gynae surgery are "a thing" that changes the way that affected tissue works rarely gets mentioned. For example, a bowel distorted by adhesions might not work as well as it should because it won't move in a normal way, or at all, and causes pain. This often gets labelled "IBS" and used to be "treated" with anti-depressants - never pain relief. I would guess these days that it is "treated" with CBT or nothing and the patient is labelled with a "functional" condition or is labelled as a hypochondriac, drug-seeker, or mentally ill.
 
Deanne NZ said:
Is it possible that the Oslo consortium spin doctors wrote this with the intention of Wilson & Dunbar putting their names to it? Or at least spoon-fed them the key points and links?
Click to expand...
They do link to it, so at least it influenced them, but referring to them as "a Scandinavian research group" suggests little familiarity with them besides agreeing with the same nonsense.
 
Research shows promising early results. One study addressed subconsciously held beliefs about the nature of the illness, which reduced the fatigue of Long COVID, with sustained effects at six months.
Click to expand...
This stuff should lead to merciless piling on, disqualification even. No serious person should read anything surrounding anything like this with anything but total contempt, it is completely unserious.

But instead this is the future of medicine, unquestioned by most, unopposed by almost all. At least until technology makes this entirely obsolete. Space age cutting edge science for some, yoga, kale smoothies and complete bullshit for the rest.
 
One study addressed subconsciously held beliefs about the nature of the illness, which reduced the fatigue of Long COVID, with sustained effects at six months.
Click to expand...

Referencing Efficacy of Cognitive-Behavioral Therapy Targeting Severe Fatigue Following Coronavirus Disease 2019: Results of a Randomized Controlled Trial (2023, Clinical Infectious Diseases) which as I recall talked about dysfunctional beliefs, though not specifying them as subconsciously held.

Anyway, an ironic phrase to use in this piece, given the absence of thinking going on here. Subconsciously held beliefs? That's you lot, not the patients.
 
SNT Gatchaman said:
Not a recommendation, with a giveaway being the use of "CFS/ME"

https://theconversation.com/success...-offers-hope-for-those-with-long-covid-232897

---

Hamish Wilson
Associate Professor in General Practice, University of Otago

John Douglas Dunbar
Clinical Senior Lecturer in Surgical Science, University of Otago
Click to expand...
The article is being republished by others. My husband spotted it on RNZ. Argh
ETA: Apparently the Herald has picked it up, too. Depressing
rvallee said:
They do link to it, so at least it influenced them, but referring to them as "a Scandinavian research group" suggests little familiarity with them besides agreeing with the same nonsense.
Click to expand...
They know exactly who and what they're referring to here. They're not the only ones in NZ citing "Scandinavian researchers" e.g. Arroll who's involved in GP training does the same. And all three of them are known and active promoters of the LP and the Switch (similar concept developed by a former LP practitioner). All three of them like to dress those commercial programmes with a sheen of scientific credibility. They're counting on Kiwis making the assumption that any research coming out of Scandinavia is high quality. I don't know if it's a highly coordinated strategy but there are no coincidences here

ETA: added the word "commercial" for the benefit of new readers who could be misled to think these programmes are mainstream medical therapies, they're not
 
Last edited:
The radio interview has broadcast and it was appalling. Dr Wilson back-pedalled early on to clarify their suggestion is based on success in treating chronic pain with therapy and therefore it should apply to chronic fatigue & long covid because of how brains work & modern neuroscience etc. Dr Dingbat was late to join the interview (???) and waffled about Thoughts, Feelings & Beliefs and was not at all inspiring. On the whole I can't see many listeners being convinced that their ideas have any merit, but it sows the seeds of doubt. I think they would have angered the many chronic pain sufferers who have been through pain clinics and not recovered. I would hope that any doctors listening were cringing.
https://www.rnz.co.nz/national/programmes/sunday/audio/2018944818/hope-for-those-with-long-covid
 
Deanne NZ said:
The radio interview has broadcast and it was appalling.
Click to expand...
I felt embarrassed for Dr Hamish Wilson, he came across very badly, it certainly was cringeworthy. He obviously planned to highlight the fact that this is all backed by neuroscience, saying that many times. But when Brian Crump tried to dig into things a bit more, he had nothing but repeating 'the neuroscience is very helpful'. I think Dr Dunbar realised how badly things were going and tried to go over the ground again. It was very clear that they were just hoping they could help Long Covid, that this idea was not really based on anything.

Brian Crump said that Long Covid seemed to have an immunological basis and asked 'was this also being caused by the brain?', to which one of the doctors replied something like 'ah well, it's all connected'.

I worry about a lot of the material put out by the psychosomatic crowd, that it will convince people who believe the mind is powerful. But this I think probably counts as a backfire, as far as getting a message out there that Long Covid can be fixed by rehabilitation.

Here's the link, enjoy
https://www.rnz.co.nz/national/programmes/sunday/audio/2018944818/hope-for-those-with-long-covid
Long-term fatigue is often paired with debilitating chronic pain - and its effects have been underplayed for too long. Hamish Wilson and John Douglas Dunbar join Bryan to discuss the growing understanding of the neurological effects on pain in the wake of Covid-19 and how this is providing sufferers with optimism.
Click to expand...

Edit - I just listened to it again as I wasn't paying close attention the first time. Dr Dunbar didn't cover himself with glory either, there was an analogy with goldfish in a bowl and the fish food was put into the bowl and the food drifts down into the water and the surface of the water is like the boundary between conscious thought and the subconscious and, well, I'm not sure. He lost me on the second listening too. Are the goldfish just innocent bystanders in this analogy?
 
Last edited:
Deanne NZ said:
clarify their suggestion is based on success in treating chronic pain with therapy and therefore it should apply to chronic fatigue & long covid because of how brains work & modern neuroscience etc
Click to expand...
In the end, exactly how every alternative medicine practitioner defends their work. They know it works, they've seen it work, and they have models and beliefs about why it works, they can show you pamphlets and videos. For a price. And now thanks to pseudoscience having become mainstream medicine, the non-official quacks use exactly the same BS arguments as the licensed quacks. The. Exact. Same. It doesn't seem to bother any of them.

This is something beyond post-truth, although that term is overused since truth never really mattered all that much. It's so much worse, and not just because it now has official power over real people, has legal weight despite being complete hot air. It's the absolute peak of pseudoscience.

All because it can't be measured. That's all it really is in the end. If it could be measured, this nonsense would never have gotten anywhere. But this is an area where math doesn't apply, the rules of logic don't matter, even outcomes are irrelevant. It's just a return to old shamanism with the raw application of power, justified by modernized pseudoscience.
 
You must log in or register to reply here.
Back
Top Bottom