Asaf (Klaf) Weisman

Triad – Three papers that point to a new paradigm By: Milton Cohen, John Quintner, and Asaf Weisman We present a triad of our recent papers that we believe hold a key to breaking the stalemate theoretical position that the science and practice of …

A new blog about our recent three publications on the Nociceptive Apparatus Paradigm

#painresearch #physio #neuroskyence

painlosophy.wordpress.com/2025/12/06/t...

Association between MRI findings and inflammatory symptoms in non-specific chronic low back pain - European Spine Journal European Spine Journal - Non-specific chronic low back pain (nsCLBP) likely constitutes a heterogeneous group of conditions, and identifying an inflammatory phenotype may improve treatment...

💥Interesting new study indicates that multilevel abnormalities in Lumbar MRI correlate with an inflammatory phenotype of low back pain.

#painresearch #neuroskyence #physio

Open access: link.springer.com/article/10.1...

This new prospective study followed 108 individuals with acute low back pain. Their immune profiles predicted transition from acute to chronic low back pain in a sex- and age-specific manner with some pretty impressive AUCs.

journals.lww.com/pain/abstrac...

#neuroskyence #painresearch #physio

Potential and actual tissue damage are encoded the same. Both qualify as nociception. It is an ingenious evolutionary adaptation that is meant to protect us way before actual damage occurs.

Pinch yourself slightly hard and you will likely feel pain due to potential tissue damage.

Officially published💥 A reboot to the #pain field! The aphorism that “nociception is neither necessary nor sufficient for pain” has caused a lot of damage to patients and set back the field and should be discarded.

#neuroskyence #painresearch #physio

Free link: academic.oup.com/brain/advanc...

The interplay between metabolic disorders and tendinopathies: Systematic review and meta‐analysis This systematic review highlights a strong link between metabolic conditions and tendinopathies. Diabetes significantly increases the risk, especially for Achilles and upper limb tendinopathies. Dysl...

Metabolic disorders and pathophysiologies have many detrimental effects and are associated not only with tendinopathies but also with chronic #pain and are highly likely to be causal for these. This new review finds that diabetes has crazy effect sizes for many types of tendinopathies
#physio #pain

Very important and useful clinical information on the average age of onset of autoimmune diseases.

From: www.thelancet.com/journals/lan...

#physio #painscience

A new medical illustration I made per request. I wish I could just do those all day.

#painscience
#neuroskyence
#physio
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They found a population of noxious heat and chemical irritation processing neurons - not “pain” and not “itch specific neurons”

Do Psychological Factors Explain the Persistence of... : The Clinical Journal of Pain education program. Methods: One hundred forty-three individuals with persistent RCRSP were included in this prospective cohort study. At baseline, participants completed self-reported questionnaire...

According to Betteridge's law of headlines, the answer to the titles question is: NO!
The study found MICROSCOPIC effect sizes for the contribution of psychological factors in the persistence of shoulder pain!

#physio #painscience
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journals.lww.com/clinicalpain...

Suzetrigine, a Non-Opioid NaV1.8 Inhibitor With Broad Applicability for Moderate-to-Severe Acute Pain: A Phase 3 Single-Arm Study for Surgical or Non-Surgical Acute Pain Many patients experience inadequate pain control due to limited options that are both efficacious and safe for treating moderate-to-severe acute pain; therefore, opioids are still frequently prescr...

First phase 3 trial for the novel non-opioid drug Suzetrigine. It’s not placebo controlled and aimed to test the safety profile of the drug. I am not sure wheter this could be considered “well-tolerated” and “generally safe”

#physio
#painscience
#neuroskyence
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www.tandfonline.com/doi/full/10....

The obvious questions are: how did they get those mice to report they were experiencing pain? And since when pain is being processed anywhere in the brain when pain is a response and the outcome of all processing?

Evidence for peripheral neuroinflammation after acute... : PAIN a subgroup with underlying nerve involvement in WADII, such as peripheral neuroinflammation. This study aimed to investigate the presence of neuroinflammation in acute WADII using T2-weighted magnetic...

New study finds evidence for neuroinflammation in the periphery of individuals after WHIPLASH. Very well conducted study! Sample size ✅ control group ✅ Sig. findings on MRI ✅ Sig. findings on blood tests ✅ Sig. findings on QST ✅

#physio
#neuroskyence
#painresearch
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Evidence for peripheral neuroinflammation after acute... : PAIN a subgroup with underlying nerve involvement in WADII, such as peripheral neuroinflammation. This study aimed to investigate the presence of neuroinflammation in acute WADII using T2-weighted magnetic...

New study finds evidence for neuroinflammation in the periphery of individuals after WHIPLASH. Very well conducted study! Sample size ✅ control group ✅ Sig. findings on MRI ✅ Sig. findings on blood tests ✅ Sig. findings on QST ✅

#physio
#painresearch
#neuroskyence

journals.lww.com/pain/Fulltex...

Fibromyalgia is a rabbit hole by itself. What have you learned from your quest?

Altered manifestations of skin disease at sites affected by neurological deficit The contribution of the nervous system to inflammation in general and inflammatory skin disease in particular has been underappreciated. It is now apparent that the conventional clinical manifestation...

Link includes 16 other examples

pmc.ncbi.nlm.nih.gov/articles/PMC...

Striking cases of neuro-immune interactions: Upper pic: Psoriasis vanished from right hand after shoulder dislocation with brachial plexus injury. Bottom pic: Four months later, as nerves began to recover, psoriasis returned.
#neuroskyence
#painresearch
#physio
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Trigeminal nerve microstructure is linked with neuroinflammation and brainstem activity in migraine Using multimodal imaging, Tohyama et al. show that individuals with migraine have white matter damage in the trigeminal nerve. This damage is associated wi

New study with combined 7 Tesla MRI imaging and PET scan finds altered structures of nerves and neuroinflammation in migraine patients. Vey robust design that includes a control group and same cases as right/left side dominant migraines as controls.
#painresearch
#neuroskyence
#physio
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US drug agency approves potent painkiller — the first non-opioid in decades The FDA’s nod for suzetrigine bolsters confidence in the pharmaceutical industry’s strategy to target sodium channels.

FDA approves new pain killer- First non-opioid analgesic in decades targets sodium channels.

#painresearch
#physio
#neuroskyence
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www.nature.com/articles/d41...

New imaging technique published in Nature to image inflammation utilizes the protein CD-45 which is used only by white blood cells.

Link: Link: www.nature.com/articles/s41...

#painresearch
#physio
#neuroskyence
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Read more in our paper.
Open access: www.sciencedirect.com/science/arti...

It just means that the mode of activation is not nociceptive nor neuropathic. Unfortunately, the term nociplastic pain has been hijacked by those with vested interests to sell and promote psychological treatments for those with “non structural pain. Do not cooperate with this trend!

This activation can occur due to three mechanisms: nociceptive, neuropathic and nociplastic. It is now known that activation of nociception can occur independently and without observed tissue damage (nociplastic). This does not make nociplastic “non structural pain”

There is no such thing as “STRUCTURAL PAIN” and “non structural pain” etc. The plethora of unpleasant sensory experiences we humans use the word “pain” to describe them, are all the consequences of activation of our specialized appartus of nociception.
#painresearch
#physio
#neuroskyence

It should be obligatory for every med/life sci grad student to learn formal logic & reasoning. Too many published papers are poorly argued and make basic inferential errors. This small change would dramatically improve science

#physio
#painresearch
#neuroskyence
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⭐️Surgery should be considered if leg pain and decreased walking distance are the main clinical features that disturb and affect the patient.

⭐️Eventually, at one year follow-up, both groups equalized in their outcomes,but the surgery group improved faster.

⭐️Functional tests are good at reflecting the subjective self assessment of patients with Spinal Stenosis and can be used for shared decision making.

What you can learn from the study:

⭐️ Leg pain and the decreased ability to walk are the main features that led those who opted for surgery.

⭐️Contrary to the vilification trend of lumbar surgery in healthcare, those with leg pain improved significantly faster than the wait and see group.

The Clinical Status of Patients With Lumbar Spinal Stenosis ... : JAAOS - Journal of the American Academy of Orthopaedic Surgeons oth groups were assessed at baseline (t0) and 3 months (t1), with additional self-reported measures at 6 (t2) and 12 months (t3). Key outcomes included corridor walk distance, chair sit-to-stand repet...

💥New publication from our lab with some important clinical nuggets.
We followed 2 groups of patients with Lumbar Spinal Stenosis and leg pain, who decided to undergo surgery or to “wait and see”
A 🧵

journals.lww.com/jaaos/abstra...

#physio
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#orthosky
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