I’ve said it before and I’ll say it again, pain scales and intensity do not tell the true picture of a persons pain and or suffering
David Poulter
@retlouping.bsky.social
Dislikes evidence based Ostriches (An evidence based ostrich ignores evidence against whilst waiting for evidence of support.)
Our contextual effects paper is now part of a publishe e-book “Optimizing the Therapeutic Potential in Clinical Settings: Leveraging Placebos and Mitigating Nocebo Effects” www.frontiersin.org/research-top...
Optimizing the Therapeutic Potential in Clinical Settings: Leveraging Placebos and Mitigating Nocebo Effects
The placebo effect holds a crucial yet often overlooked role in clinical care, representing intrinsic and potentially powerful components of any therapeutic intervention. Decades of predominantly expe...
frontiersin.org
Latest blog, enjoy written in the Azores My Burnt Hand, cold water and painsplaining retlouping331888347.wordpress.com/2026/05/10/m...
My latest blog Clinicl reasoning a whimsical view. retlouping331888347.wordpress.com/2026/05/06/c...
Clinical reasoning a whimsical view
Clinical reasoning in healthcare involves three main, interconnected types—deductive, inductive, and abductive—used to diagnose and treat patients effectively. Abductive reasoning identifies t…
retlouping331888347.wordpress.com
My 100th blog Much ado about nothing A whimsical look at placebo. retlouping331888347.wordpress.com/2026/04/22/m...
Much ado about nothing
A whimsical look at placebo, sham and contextual effects. 🅿🅻🅰🅲🅴🅱🅾 Nothing. 👇 🅿🅻🅰🅲🅴🅱🅾 + priming Look at this beautiful slide of a polar bear in a snow storm against an icy background. Stare at the b…
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When people talk about “pain signals” from the brain how do people who say this perceive the signal gets to the extremity or area of original nociception? There are no nerves from the brain to the periphery carrying “pain signals” Pain is a perceptual experience not a signal.
Revisiting McKenzie’s original thoughts on tissue deformation and pain. retlouping331888347.wordpress.com/2026/04/17/r...
Revisiting McKenzie’s original thoughts on tissue deformation and pain.
In his original text Mechanical Diagnosis and Therapy, The Lumbar spine, McKenzie wrote the following. “For scarring to take place, and as scarring increases the concentration of chemical irritants…
retlouping331888347.wordpress.com
Latest blog Human Posture: Controversy, Evidence, and Temporary Solutions retlouping331888347.wordpress.com/2026/04/17/h...
Human Posture: Controversy, Evidence, and Temporary Solutions
By David Poulter (@Retlouping)Originally posted as a Twitter thread on March 24, 2022, with ongoing updates through 2025. Transposed into this readable blog format while preserving all original tex…
retlouping331888347.wordpress.com
Discovering the Gentle Power of Homeopathy: Real Healing Beyond the Skeptics retlouping331888347.wordpress.com/2026/04/16/d...
Discovering the Gentle Power of Homeopathy: Real Healing Beyond the Skeptics
Hopefully you won’t think I’ve gone mad. This was a challenge to show how we can spin anything even “useless treatment” using evidence and of course AI. Thanks for the suggestion Matt. Discovering …
retlouping331888347.wordpress.com
“Hey listen to how I treat my own pain and what you need to avoid” is no more valid because you study pain or have a PhD. It is still n of 1 anecdote. Scientists commit the same fallacies as lay people all the time.
Latest blog: Understanding torticollis retlouping331888347.wordpress.com/2026/04/10/u...
Understanding Torticollis
A brief AI review to begin this blog. This text explores the developmental anatomy and clinical management of torticollis, focusing specifically on the role of the unc…
retlouping331888347.wordpress.com
Latest blog Choose your words with care, but don’t “word shield” retlouping331888347.wordpress.com/2026/04/09/c...
Choose your words with care, but don’t “word shield”
🎵 You think that I don’t even meanA single word I sayIt’s only words and words are all I haveTo take your heart awayIt’s only words and words are all I haveTo take your heart away…
retlouping331888347.wordpress.com
Cycled into central London to Marylebone to meet up with @DrZoffness for lunch. She is in London doing promotional work for her new book “Tell me where it hurts” serendipitously I was in London too.
Why do we get acute deformities. My latest blog. No AI involved. retlouping331888347.wordpress.com/2026/03/30/w...
First in Best Dressed: Why the Information We Learn First Sticks the Longest — And Why Unlearning Is So Tough retlouping331888347.wordpress.com/2026/03/28/f...
The lesser quoted Brinjikji et al study MRI Findings of Disc Degeneration are More Prevalent in Adults with Low Back Pain than in Asymptomatic Controls: A Systematic Review and Meta-Analysis www.ajnr.org/content/ajnr...
A Brief Thread on Learning: Rethinking Patient Education in Pain Science retlouping331888347.wordpress.com/2026/03/23/a...
A Brief Thread on Learning: Rethinking Patient Education in Pain Science
by David Poulter (@Retlouping)Originally posted on X (formerly Twitter) – 29 January 2021 This blog post transforms the original X thread into a clean, readable long-form article while preserving t…
retlouping331888347.wordpress.com
Thread to blog: Understanding Spondylolisthesis: The Five Types (Not Just the Grades) – A Clear, Evidence-Based Overview retlouping331888347.wordpress.com/2026/03/23/u...
Another thread to blog. The History of Lumbar Shift Correction: Evolution of a Technique, Clinical Reasoning, and Patient Empowerment retlouping331888347.wordpress.com/2026/03/22/t...
The History of Lumbar Shift Correction: Evolution of a Technique, Clinical Reasoning, and Patient Empowerment
A comprehensive long-form exploration based on the insightful thread by David Poulter (@Retlouping), a clinician with 40+ years of hands-on experience in spinal care. This blog post compiles and ex…
retlouping331888347.wordpress.com
A Provocative Ponderance Parable: Mechanisms of Causation vs. Sources of Pain retlouping331888347.wordpress.com/2026/03/21/a...
A Provocative Ponderance Parable: Mechanisms of Causation vs. Sources of Pain
By David Poulter (originally shared as a Twitter/X thread in 2022)Adapted into blog format with all original images and intent preserved. This is a light-hearted but powerful analogy for clinicians…
retlouping331888347.wordpress.com
The paradox is real and reflects a tension in modern musculoskeletal (MSK) practice. The Biopsychosocial model v the rise of diagnostic ultrasound. retlouping331888347.wordpress.com/2026/03/20/t...
The paradox is real and reflects a tension in modern musculoskeletal (MSK) practice. The Biopsychosocial model v the rise of diagnostic ultrasound.
Screenshot This article was generated by Grok AI based on my question and concern about the paradox of MSK clinicians pushing the Biopsychosocial model yet also promoting the use of diagnosis ultra…
retlouping331888347.wordpress.com
Another thread to blog Rethinking Inflammation: Acute Repair vs. Chronic Repair. retlouping331888347.wordpress.com/2026/03/20/r...
Another thread to blog post thanks to Grok AI Understanding Spinal Stenosis: A Physiotherapist’s Clear, Practical Guide retlouping331888347.wordpress.com/2026/03/19/u...
Understanding Spinal Stenosis: A Physiotherapist’s Clear, Practical Guide
David Poulter (@Retlouping) is a physiotherapist with decades of hands-on experience in spinal conditions. In April 2020 he posted a detailed “dinosaur twittertorial” (his words) explaining stenosi…
retlouping331888347.wordpress.com
Experience and Expertise in Clinical Care: Is There a Difference? retlouping331888347.wordpress.com/2026/03/16/e...
Experience and Expertise in Clinical Care: Is There a Difference?
A thoughtful exploration by David Poulter (@Retlouping) – Physiotherapist, McKenzie Method advocate, and lifelong learner in evidence-based practice. Originally posted as a Twitter/X thread on 6 Oc…
retlouping331888347.wordpress.com
Let’s do text book neck next 😂 Text neck and neck pain in 18-21-year-old young adults pubmed.ncbi.nlm.nih.gov/29306972/ This study did not show an association between text neck and neck pain in 18-21-year-old young adults.
Poulter’s Paradox: The Hips, Pelvis, SI Joint, and Lumbar Spine retlouping331888347.wordpress.com/2026/03/14/p...
Poulter’s Paradox: The Hips, Pelvis, SI Joint, and Lumbar Spine
By David Poulter (@Retlouping)Adapted and formatted from the original X thread (updated September 23, 2022) Introduction In the “old man screaming at clouds” series, today’s topic is Poulter’s Para…
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Another thread to blog transfer Directional Preference vs. Accommodation Positions: A Crucial Distinction in Musculoskeletal Self-Treatment retlouping331888347.wordpress.com/2026/03/13/d...
Directional Preference vs. Accommodation Positions: A Crucial Distinction in Musculoskeletal Self-Treatment
Adapted and compiled from the original 2021 X thread by clinician David Poulter (@Retlouping), with later updates and supporting references included for full context. This distinction is especially…
retlouping331888347.wordpress.com
A new thread to blog. It outlines why I don’t do the standard McKenzie exam that you may have learnt on a McKenzie course. Synergistic History and Examination: The ACTIVE/INACTIVE Model and BIG PICTURE Assessment retlouping331888347.wordpress.com/2026/03/12/s...
Synergistic History and Examination: The ACTIVE/INACTIVE Model and BIG PICTURE Assessment
Below is a thread I wrote and has beed transposed for me by Grok AI so that it is now a blog post and transferable to other apps. I have often been critical of how the McKenzie system is used and a…
retlouping331888347.wordpress.com