Surgery is often a consideration for many people with back pain, it's the top of the medical triangle, and many believe it will fix them. But Orthopaedic Surgeon, Scientist and Author, Professor Ian Harris, see's it differently. In this episode, he talks to Prof. Peter O'Sullivan, Dr JP Caneiro and Kevin Wernli about all things surgery, placebo, research and pain. We also hear the story of Steve, a 26year old who had disabling back pain for 6 years, was on strong opioids, had multiple surgeries including a spinal fusion, but was still battling. Fortunately, he found his way onto a study researching back pain that Kevin Wernli completed as part of his PhD. 

Key things discussed: 
- The effectiveness (or not) of spinal surgery. 
- Why there are such differences in outcomes in workers compensation patients.
- Is pain all in your head? 
- Alarming rates of increasing surgery rates in the private sector vs public sector, and why that might be. 
- A call for better evidence (and who should fund it!).
- The key question patients NEED to ask their healthcare professionals. 

Show notes available at https://www.bodylogic.physio/podcast 

A huge thanks to ABC and ABC 730 for granting us permission to use their content for educational purposes. 

Twitter handles @EBPPodcast @PeteOSullivanPT @JPCaneiro @KWernliPhysio 
*Peter O’Sullivan and JP Caneiro were awarded specialisation by the Australian College of Physiotherapists in 2005 and 2013 respectively. Theme music by Fervun and Cash. For educational purposes only. Created and produced by Kevin Wernli

Pain flare ups are unfortunately common, and they can be really distressing, especially if your feeling like you've been making good progress. But there are some misconceptions which can keep you in a loop. Professor Peter O'Sullivan and Dr JP Caneiro discuss patient voice Jamie's journey through the ups and downs of flare ups. 

My take homes:
- Flare ups, while not pleasant, are unfortunately common and a pretty normal part of recovery. 
- While they can be terrifying in the moment, the don’t last forever, and can be an incredible learning opportunity. 
- They are usually more related to things that sensitise our system, like poor sleep, stressful times, being more sedentary, working longer hours, not having time to recover or doing too much too soon, and infrequently relate to creating further damage - even though it may be really painful. 
- Although it can feel like a big step back and that you’ve un-done all your progress, this is rarely the case, you may find it helpful to think of it as a temporary ‘pause’ on your progress, not a restart. 

Show notes available at https://www.bodylogic.physio/podcast Twitter handles @EBPPodcast @PeteOSullivanPT @JPCaneiro @KWernliPhysio *Peter O’Sullivan and JP Caneiro were awarded specialisation by the Australian College of Physiotherapists in 2005 and 2013 respectively. Theme music by Fervun and Cash. For educational purposes only. Created and produced by Kevin Wernli