A quiet revolution in pain understanding and treatment is happening in some parts of the world. Along with locals and other visitors, I have just spoken at a conference in Valladolid in Spain. Valladolid is the home of Cervantes, some of the finest Verdello I have ever drunk and one D. Rio del Hortega (1882-1945) who was first to observe that microglia were mobile in the central nervous system. This was a sold out conference, full of young (average under 30 I guessed) physios and some medicos. Unlike a conference at home or in the US they all stayed right to the end and the place bubbled with enthusiasm.
As I wandered back to my hotel room I thought – that was rare in the world, 550 physios at a conference just on pain! I hoped they could all continue a professional life powered by science and reason and not be trapped by concepts and systems. And I hoped that the local universities could be nimble enough to support by adapting and focussing teaching resources. I hoped that the Spanish would not suffer the same problems with opiates that the US, Australia and other countries have and that alternative evidence based approaches for chronic pain could be ramped up to prevent this. I hoped that the participants could be rewarded with a fair wage commensurate with the societal savings possible from best practice. And I hoped that the powerful English speaking health world would pause for a moment and reflect and learn from practice elsewhere.