We have an action-packed newsletter for you all. Plus- great news, the dates for the next APS 2023 conference have been released. Yay Canberra here we come! As a starter, both topical and abstract submissions are now open. Also get your nominations in now for the Rising Star and Distinguished Member awards. If you are thinking of attending the conference, but not sure of what it can provide for your career, then check out the two great short inspirational articles from travel grant recipients and how much of an impact it was for them to be able to attend the conference.
It is great to be able to showcase some new publications by our APS members in this newsletter. The Basic Pain Research Special Interest Group (BPR SIG) Journal Watch is also back. It is such a fabulous opportunity to be able to communicate on recent publications by our members, and our readers are asked to please be mindful to share their articles as they come to hand as well.
We are also highlighting a member’s spotlight and for this issue we are catching up with Dr David Holloway, the director of electronic Persistent Pain Outcomes Collaboration (ePPOC) and how he came to join the ePPOC board. Dr Holloway also shares with us his thoughts on what he thinks the next ‘hot topics’ will be based on the ePPOC’s data set. Lots of opportunities to be explored there and some very sage advice for those focusing on their pain career.
Keep sharing your stories, Until next time, take care
Joanne Harmon
Welcome to my latest President’s report.
It was fantastic to see so many of you face to face at our successful annual scientific meeting (ASM) in Hobart in April. The weather was magnificent, the program and speakers were enthusiastic and engaging and the “vibe” was particularly special this year - I think it’s safe to say we all missed seeing each other. Thanks again to Alex Robertson from DCC&A, the local organising committee led by Dinah Spratt and the scientific program committee under the leadership of Kevin Keay for all of your hard work in preparing a successful ASM.
We are so excited to be finally presenting painSTAR, our inaugural immersive and interactive pain school from November 13-17, 2022 at the Novotel Barossa Valley. As you might remember, we’ve had to postpone painSTAR the past couple of years because of the COVID 19 pandemic. Pain schools such as this foster interdisciplinary collaboration, an acceleration of research translation from bench to bedside and literally put a face to persistent pain by exposing participants to the personal and social consequences of pain by our consumer representatives. Thanks to sponsors including the International Association for the Study of Pain (IASP), the Faculty of Pain Medicine (FPM) and the Australian Rheumatology Association (ARA).
Speaking of pain schools, I’m proud to announce that the APS is also sponsoring a participant from either Papua New Guinea, Timor L’este or the Pacific Islands to attend the Association of Southeast Asian Pain Societies (ASEAPS) pain camp in Bangkok from April 30 – May 2, 2023. This sponsorship will help to cover travel and accommodation costs for a participant. We are pleased to continue our association with ASEAPS, having offered the ASEAPs Award since 2013 to enable a participant to attend our ASM each year.
The Board held a strategic planning review meeting on Saturday August 20, 2022 via Zoom to assess our progress in achieving our
key goals. The APS is advertising for the Cops for Kids Clinical Research Grant #6 (so get in quickly and apply for this excellent grant), as well as reviewing applications now for our APS PhD scholarship for 2023, preparing a position statement on pain in the elderly and developing a mentorship program (just to name a few!). Thanks as always, to the team for volunteering their time and efforts on the Society’s behalf.
Planning is proceeding for our next APS conference in Canberra for 2023. Get in early and arrange your leave for April 2-5, 2023 and join us at the National Convention Centre. Keynote speakers include Associate Professor Melanie Noel from Calgary, Canada, and Professor Ted Price from Texas, USA. Both are very keen and excited to attend. Don’t forget October 2022 is an important month as this is when deadlines for topical sessions, free papers and poster presentations etc are due.
That’s all for now - stay well and look out for each other.
Now Open!
Topical Session Submissions Open
Rising Star Award Applications Open
Free Paper/Poster Abstract Submissions Open
Tuesday 11 October 2022
Rising Star Award Applications Close Topical Session Submissions Close
Tuesday 25 October 2022
Free Paper/Poster Abstract Submissions Close
Tuesday 15 November 2022
Registrations Open!
APS 2023 will be held from 02 – 05 April 2023 at the National Convention Centre Canberra, ACT
Please visit the conference website here: www.dcconferences.com.au/aps2023
If you have any questions, please contact the APS Conference Secretariat: apsasm@dcconferences.com.au
On behalf of the Scientific Program Committee and the Local Organising Committee, we are pleased to advise topical session submissions for APS 2023 are now open.
The deadline for Topical Session submissions is: Tuesday 11 October 2022
View the topical session submission guidelines.
The online topical session submission portal is now available via the conference website.
We look forward to receiving your submissions. Should you have any queries regarding your submission or the process, please contact the Conference Secretariat.
Submissions closing: Tuesday 25 October 2022
On behalf of the Scientific Program Committee and the Local Organising Committee, we are pleased to advise that abstract submissions for APS 2023 are now open.
Please note the following points regarding the submission process:
• If your abstract is accepted, either as a free paper or poster, there is an expectation that you will attend the conference to present this paper.
• The person submitting MUST be the main author AND will present the work at the APS ASM.
• Expressions of Interest (EOI) for travel grant applications are also being collected as part of the submission process.
To view the abstract submission guidelines please click here
There are THREE categories for Abstract Submissions. Please visit these portals below:
Experimental Studies & Clinical Trials Abstract Portal
Clinical Practice & Service Delivery Abstract Portal
Case Reports Abstract Portal
Delegates wishing to apply for a travel grant must be the major contributor and submitting author of the abstract. Only delegates who have ticked ‘yes’ to the Travel Grant section of the abstract submission process AND completed the associated application form will be considered. For further information on the separate Travel Grant Application Form process and to ensure you meet the terms and conditions please click here.
We look forward to receiving your submissions. Should you have any queries regarding your submission or the process, please contact the Conference Secretariat
We look forward to receiving your submissions. Should you have any queries regarding your submission or the process, please contact the Conference Secretariat.
Submission Deadline: Tuesday 11 October 2022
This award showcases rising star pain researchers in Australia and may be awarded annually subject to the application of suitable candidates. The Rising Star Winner will receive a return domestic airfare, accommodation, and complimentary registration to attend the 2023 APS 43rd ASM where they will give a plenary presentation to showcase their work and ideas.
Applications are now open, for further information and to apply, please click here.
• Nominees must hold a PhD and be within five (5) years of conferral by the deadline of this award application.
• Applicants must be a member of the APS
BLOG WEB
• Applicants can be working in any field of pain research, including basic science, biomedical, clinical, and other applied or cross-disciplinary sciences.
• The selection committee will consider personal or extenuating circumstances that might provide grounds for consideration if the above eligibility criteria are not met.
Please include details in the nomination form such as:
- Time out for maternity/parental leave/carer’s leave/ illness
- Significant breaks in research time (e.g., due to clinical work, reduced research-focussed post-doctoral employment)
- Pro rata (so relative to opportunity for those working as clinicians or teaching/research posts)
• Only individual scientists are eligible (not research teams)
• Applicants must be available to attend APS 2023, and to deliver the Rising Star presentation
• Applicants must be an Australian citizen/resident, currently working in Australia and have spent at least two post-doctoral years in Australia, or have returned to continue working in Australia
This award will be based on excellence in pain-related research achievement, demonstrated from the applicant’s track record, including:
• Specific research achievements or discoveries
• Research impact/application
• Collaboration achievements – independent of your supervisor
• Publication record (quality and impact of publications, e.g., H-index, standing of journals, citations)
• Grants obtained (as a Chief Investigator)
• Patents held
• Peer recognition: Awards or prizes, national profile, international profile.
For further information and to apply, please visit the Rising Star Application Guidelines.
We look forward to receiving your submission!
The Board of Directors is seeking nominations from all Australian Pain Society (APS) members for candidates to be considered for the Distinguished Member Award(s) to be presented at the APS 43rd Annual Scientific Meeting to be held in Canberra from 2 - 5 April 2023.
• Candidates must be APS members who generally have had a lengthy career in the field of pain and have:
• Made major contribution1 towards the Society, and
• Significantly contributed to the science of pain management, and/or
• Played a significant clinical, educational or research role in the field of Pain Management in Australia.
1 Major contributions include, but are not limited to:
Scientific Program Committee involvement
– Pain research
– APS projects
– Subcommittee involvement
– Board liaison
Contributions to ASM presentations
Nomination Guidelines:
• A ‘Nomination for Distinguished Member Award’ form must be completed.
• As a guide, it is desirable that nominees have held continuous APS membership for over 10 years.
• Nominations must include an 800-900 word biography of the nominee. The Board will not consider incomplete nomination forms.
• Unsuccessful nominations are not automatically put forward in subsequent years.
• The nominator must be prepared to present a brief summary of the Distinguished Member biography in the ASM program, or arrange a suitable alternate for the presentation segment.
Submission
• All nominations to be submitted to the APS Secretariat by 31 October 2022.
Notification:
• The APS Board will notify successful nominees by 31 December 2022.
• Distinguished Member recipients are actively encouraged to attend the Annual Scientific Meeting in order to receive their award in person from the APS President.
The nomination form and a listing of past recipients of the Distinguished Member Award, including their biographies, can be found on the APS website.
Jayden is an end-of-candidature PhD student at the University of Sydney investigating neuroimmune interactions in the brain, skin, and blood in chronic neuropathic pain states. He was an inaugural virtual correspondent for the IASP Pain Research Forum in 2020.
Author contact details: jayden.obrien@sydney.edu.au
Nearly two years after hearing that the IASP World Congress in Amsterdam – and by extension my opportunity to present there –was cancelled due to the pandemic, it was a true delight to have the APS ASM 2022 as my first ever in-person scientific meeting. Thanks to the Travel Grant, I was able to immerse myself without limitation in the talks, workshops, presentations, and networking events that made it a thoroughly enjoyable foray into scientific conferences and one that helped me, for the first time, feel like a genuine part of the Australian pain research and care community.
On the Sunday, I was enabled to attend the Basic Pain Research Special Interest Group (BPR SIG) pre-conference workshop, where I met a wide array of basic pain researchers and encountered some familiar faces as well – of whom immediately made me feel right at home. Here I presented a three-minute thesis talk on the potential neuroinflammatory basis of affective changes in rats with neuropathic pain, as well as single-cell immunophenotyping of blood in painful diabetic neuropathy to isolate specific cell types relevant to pain maintenance. My thanks to Jason Ivanusic and Michael Morgan for this great opportunity. After my presentation, I had the pleasure of some great conversations regarding the mechanics of my experimental rat model, as well as the potential applicability of similar single-cell approaches to other chronic pain conditions such as adolescent pelvic pain. It was also valuable to see the work of other early career researchers on neuropathic pain, such as Lipin Loo’s presentation on single-cell
When the conference proper kicked off, the highlights continued. Among these was an excellent interactive topical session on clinical (and preclinical!) placebo and nocebo developed and presented entirely by early-mid career researchers – a truly inspiring session. It was also excellent to hear keynote presentations from more seasoned experts, such as Prof Andrew Rice on some clear definitions and clinical characteristics of neuropathic pain conditions, and Dr Christine Barry on chronic pain and women’s health, with particularly interesting work on neuroimmune interactions in vulvodynia.
I was also pleased to be able to present in greater detail on my preclinical rat research in the form of a poster presentation, in which I used the chronic constriction injury of neuropathic pain to show that inhibiting microglia was sufficient to prevent depressivelike behaviours in nerve-injured rats. This work was then condensed and reworked into a
90-second rapid communication presentation on centre stage – a fantastic opportunity. And when that presentation did not go all according to plan, it spoke to what a truly special community the Society is that I was met with uniformly generous and candid support. This song will forever have a new meaning for me!
As of writing this, it has not been long at all since the meeting ended, yet I am already looking forward to Canberra in 2023. Next year, I can think of nothing better for another trainee pain researcher than to be supported by an APS Travel Grant to attend a vibrant, rigorous, and supportive scientific meeting, and thereby encourage the development of the next generation of pain researchers, clinicians, and professionals.
Declaration
Jayden O’Brien has nothing to declare.
Amelia is a third year PhD candidate at the University of South Australia. Her research is focused on optimising pain science education for females with persistent pelvic pain. Author contact details: amelia.mardon@mymail.unisa.edu.au
Pelvic pain research at the Australian Pain Society Annual Scientific Meeting
I was fortunate to present my talk “Persistent pelvic pain guidelines – What do they recommend?” at the Australian Pain Society Annual Scientific Meeting 2022. This published systematic review investigated what treatments are recommended in pelvic pain guidelines and appraised their quality. We found pelvic pain guidelines are generally of poor quality, and biomedical interventions (specifically pharmaceuticals and surgery) are most commonly recommended for the treatment of persistent pelvic pain. My presentation was well received by people working and researching in the pelvic health space, and I received feedback that this presentation was timely because the state of the current Australian Endometriosis Guidelines is a topical conversation at the present time.
Historically, pelvic health research has received minimal funding and support, which is why I am very grateful to the Australian Pain Society for awarding me a travel grant allowing me to present my work in this field. This travel grant alleviated a substantial portion of my travel costs to the annual scientific meeting and, as a PhD candidate, this was highly valued and appreciated. This was also my first Australian Pain Society conference I have attended! Beginning my PhD just before a pandemic, I have been unable to attend in-person conferences for the entirety of my candidature. I could not think of a better in-person conference to attend first in my research career than the Australian Pain Society Annual Scientific Meeting. At this
conference I was able to engage with amazing clinicians and researchers passionate about pelvic health and pelvic pain. I was also able to attend topical sessions and workshops outside my research scope to broaden my knowledge in other areas of pain research. I really enjoyed the topical session “How (and how well) does pain-related education work? Balancing pragmatism with the rigor of shams”; highlighting the uniqueness of pain science education research and that science isn’t always perfect is important and the speakers of this session did a great job acknowledging this.
Since my presentation at the Australian Pain Society conference I have been busy planning studies, analysing data, and writing manuscripts. I have also been invited to present my research to other audiences in Australia. I am very much looking forward to attending the next Australian Pain Society Annual Scientific Meeting in Canberra. I am excited to see what new research will have emerged and progressions on pain science that was highlighted at this year’s conference. It will also be nice to reflect on my time as a PhD candidate and the progress I would have made over the 12-month period.
Declaration:
Amelia Mardon is a recipient of a Research Training Programme Stipend as a postgraduate student at the University of South Australia.
12-1pm, Wednesday October 19 2022 (AEDT via Zoom)
The mission of our Basic Pain Research Special Interest Group (BPR SIG) is to share, improve and promote scientific knowledge and understanding of the mechanisms of nociception and pain across all levels of investigation: from molecular and cellular analyses, to pre-clinical or clinical studies.
This forum will provide an informal platform to promote and share our research and insights, from ECRs (including students) and senior colleagues.
Summary:
This session will consider how preclinical research evidence can inform practice. This BPR Pain Hour brings together both a well-known and senior scientist, and an early career clinical researcher, with significant interest in evidence-based practice. Professor Barry Sessle has published widely in the field of animal and human basic science pain research and will provide an overview of how this has informed the diagnosis and management of dental and craniofacial pain conditions. Dr Erica Martin is a practicing dentist and has recently completed her higher research degree examining the use of the local anaesthetic Articaine. Her particular focus in dentistry has been on safety, efficacy, practitioner perception and evidencebased practice. This seminar will highlight the importance of basic pain research to inform best clinical practice in the field of dental and craniofacial pain.
The invited speakers:
• Prof Barry Sessle, Faculty of Dentistry, University of Toronto, ON, Canada
• Dr Erica Martin, College of Medicine and Dentistry, James Cook University, QLD
All are welcome to attend, including postgraduate students. We look forward to seeing you there, please register here
Journal Reference: Lesnak, Joseph B.; Fahrion, Alexis; Helton, Amber; Rasmussen, Lynn; Andrew, Megan; Cunard, Stefanie; Huey, Michaela; Kreber, Austin; Landon, Joseph; Siwiec, Travis; Todd, Kenan; Frey-Law, Laura A.; Sluka, Kathleen A.* Resistance training protects against muscle pain through activation of androgen receptors in male and female mice, PAIN: March 24, 2022 - VolumeIssue - 10.1097/j.pain.0000000000002638
DOI: 10.1097/j.pain.0000000000002638
Reviewer: Dr Michael Morgan, Research Fellow, Anatomy and Physiology, University of Melbourne
Review of Article
The study group comprised 134 male, 132 female C57/Bl6 mice who were used to study how resistance training reduces muscle pain.
Aims
The aim of this study was to determine the mechanism of resistance training-induced analgesia in an animal model of activityinduced muscle pain.
Method
Mice underwent resistance training by climbing a 1 metre ladder with 5-40g weights attached to their tails. Mice trained for 8 weeks. Animals that did not have weights attached during ladder climbing, and animals that were sedentary (no ladder climbing), were used as controls to compare the effect of resistance training.
Activity-induced muscle pain was produced by combination of two injections of pH 5.0 saline and fatigue generated by electrical stimulation of the gastrocnemius muscle. Pain was assessed by force sensitive tweezers applied to the muscle.
In one series of experiments, to determine whether resistance training protects against the development of activity-induced muscle
pain, the resistance training was performed prior to the induction of activity-induced muscle pain.
In another series of experiments, to determine whether resistance training can reverse already established activity-induced muscle pain, the resistance training was started after the induction of activity-induced muscle pain.
To explore the role of testosterone in the analgesia produced by resistance training, flutamide (an androgen receptor antagonist) was given before (once during induction) or after (ongoing throughout maintenance) of resistance training-induced analgesia Serum testosterone was also measured after a single resistance training session.
Male, but not female mice had elevated serum testosterone soon after a single resistance training session.
Resistance training performed prior to the induction of activity-induced muscle pain protected against the development of muscle pain in both males and females. But when the androgen receptor antagonist was administered with the resistance training, this effect was not observed.
Resistance training performed after the induction of activity-induced pain reversed muscle pain only in male mice, and the androgen receptor antagonist had no effect on resistance training-induced analgesia when delivered after muscle pain was established.
These data show that resistance training prevents the development of activity-induced muscle pain in both male and female mice through activation of androgen receptors. They also show that resistance training reverses already established activity-induced muscle pain in male mice.
Resistance training is a non-pharmacological therapeutic commonly recommended to those who suffer from various musculoskeletal pain conditions. However, its underlying analgesic mechanisms have not yet been elucidated. This study used a novel protocol to train mice to perform resistance training using a ladder apparatus. It demonstrated that animal models can be used to study mechanisms of resistance training-induced analgesia.
A strength of this study is that this novel approach can be used to answer basic science questions that arise from clinical
observations, questions that are not easily answered with clinical studies. The authors used this advantage to pharmacologically demonstrate the role of androgen receptors and testosterone in mediating resistance training pain relief.
This study provides a scientific basis for the use of resistance training to treat muscle pain and could provide clinicians with information as to who would best respond to resistance training for of the many chronic pain conditions it is prescribed.
Declaration
Reviewer declares no conflict of interest.
September marks Pain Awareness Month promoted by the International Association for the Study of Pain (IASP). Ideally, this month will spark more conversations and understanding about pain between health professionals, people living with pain, policy makers and the wider community.
Awareness is a priority in better pain management as outlined in the Australian National Strategic Action Plan for Pain Management.
Help IASP raise public awareness around pain, pain management, and the great work pain professionals do during the month of September...and beyond.
This year, IASP will focus on the vital importance of an individualised, multidisciplinary, and multimodal approach to pain care. Check out the IASP Pain Awareness Month resources.
Journal Reference: Jing Xie, Samuel D. Robinson, Edward K. Gilding, Sina Jami, Jennifer R. Deuis, Fabian B.H. Rehm, Kuok Yap, Lotten Ragnarsson, Lai Yue Chan, Brett R. Hamilton, Peta J. Harvey, David J. Craik, Irina Vetter, Thomas Durek, Neurotoxic and cytotoxic peptides underlie the painful stings of the tree nettle Urtica ferox, Journal of Biological Chemistry, Volume 298, Issue 8, https://doi.org/10.1016/j.jbc.2022.102218.
DOI: https://doi.org/10.1016/j.jbc.2022.102218
Reviewer: Dr Michael Morgan, Research Fellow, Anatomy and Physiology, University of Melbourne
Review of Article
The study group comprised male five-six week old C57/Bl6 mice.
Aims
The aim of this study was to determine the mechanism of pain that the New Zealand stinging nettle, Urtica Ferox, acts through.
Method
Stinging trichomes were cut from the Urtica Ferox nettle plant, contents extracted and fractionated by Reverse Phase-High Performance Liquid Chromtography (RP-HPLC), and subsequently subfractionated by RP-HPLC mass spectrometry. Painful extracts were identified on the basis of spontaneous pain behavior observed following intraplantar injection in mice.
Six pain-causing subfractions were identified and subsequently applied to cultured mouse dorsal root ganglion (DRG) neurons. Three of the subfractions elicited a strong Ca+ influx only in neuronal cells, while the other 3 subfractions caused a Ca+ influx in both neuronal and nonneuronal cells and was accompanied by dye leakage from the cells (indicative of a cytolytic effect).
High resolution mass spectrometry identified two peptides within 2 representative subfractions.
The complete primary structure of these two peptides was determined with tandem mass spectrometry analysis and matching against the messenger ribonucleic acid (mRNA) sequence of Urtica Ferox.
One peptide was a cytolytic, 4.3 kDa, 42 amino acid peptide with 3 disulfide bonds. This peptide displayed similarity to other previously identified peptides from the stinging nettle plant, and was named Urthionin-Uf1a in this study. Intraplantar injection of UrthioninUf1a caused immediate and long-lasting spontaneous pain behavior and inflammation in the injected paw.
A second neurotoxic peptide was 6.7 kDa, 63 amino acid peptide with 6 disulfide bonds and no similarity with any previously described sequence. It was named uriticatoxin-Uf2a. When purified peptide was administered intraplantar to mice, it resulted in immediate spontaneous pain behavior without inflammation, but was accompanied by hypokinesia and hypersalivation at higher doses. These two symptoms are also observed in humans and animals after envenomation by the nettle. Activation of cultured murine DRG neurons by purified uriticatoxin-Uf2a was inhibited by the sodium (Nav) channel blocker tetrodotoxin indicating it acts at Nav channels. To determine which Nav channels uriticatoxin-Uf2a acts at, automated whole cell patch clamp electrophysiology of HEK293 cells stably transfected with human Nav channels 1.5, 1.6 1.7 and 1.8 was performed. Nav 1.6 was most sensitive to uriticatoxin-Uf2a with a sub-nanomolar EC50, but the peptide also had potent (nanomolar) activity at Nav 1.5 and Nav 1.7.
This article demonstrated that the stinging nettle Urtica Ferox causes pain by envenomation with cytolytic and neurotoxic peptides. The neurotoxic peptide acts on several Nav channels with potent activity.
Stings from the Urtica Ferox nettle’s stinging hairs (trichomes) have been a cause of longlasting pain as well as visual disturbances, hypersalivation, respiratory distress, hypokinesia and occasionally death. While others have already reported histamine, 5-hydroxytryptamine and acetylcholine being present in the sting of Urtica Ferox it was not clear what caused the severe effects that had been reported.
This study took a systematic approach to identifying the pain causing mechanism of the stinging nettle Urtica Ferox. The study found that two peptides were responsible for the painful sting from the plant, but additionally found that one of the identified peptides caused
several systemic neurotoxic symptoms in mice that are also observed in humans. Further in vitro pharmacological characterization revealed that its mechanism of action was through potent activity at Nav channels, revealing potential anti-venom therapeutic strategies to treat pain and other neurotoxic symptoms upon accidental envenomation from the Urtica Ferox stinging nettle.
These results demonstrate the diverse, potent, and selective toxins that are found in stinging plants. These plants may provide a rich source of novel neuroactive peptides that could be explored for possible therapeutic compounds.
Declaration
Reviewer declares no conflict of interest.
The Australian Pain Society (APS) is keen to share publications from our members with their colleagues via our eNewsletter. If you’ve had an article accepted or published recently, please contact our Assistant Editor Joanne Harmon via the APS Secretariat (aps@apsoc.org.au) with the title, authors, and reference (i.e., journal, volume, and DOI) of your article and request the submission template. We would love it if you also supply a short commentary (300 words max) to give our readers the gist of the article.
Thank you to APS members Helen Slater, Roger Goucke, Simone De Morgan and their colleagues Joanne Jordan, Peter O’Sullivan, Robert Schutze, Jason Chua, Allyson Browne, Ben Horgan and Andrew Briggs for sharing the following recent publication.
Article first published online: 6 April, 2022
Journal Reference: https://pubmed.ncbi.nlm. nih.gov/35384928/
DOI: 10.1097/j.pain.0000000000002647
Video Abstract Link: https://links.lww.com/ PAIN/B620
Introduction
The “Listen to me, learn from me” framework was empirically-derived through a priority setting partnership. Australian people living with chronic pain and carers described the most important things health professionals needed to be able to do to help people manage their chronic pain and rated the level of importance of these pain care priorities. In a parallel study, experienced Australian health and medical clinicians working with people living with chronic pain viewed and rated these same pain care priorities.
The “Listen to me, learn from me” framework comprises 9 overarching pain care priority domains that form interdisciplinary pain
training targets, including validation; communication; multidisciplinary approaches; holistic care; partnerships; practitioner knowledge; self-management; medicines and diagnosis. A total of 44 specific pain care priority items are described under these 9 categories to guide more targeted training.
The framework repositions how we will shape and strengthen our interdisciplinary health workforce pain training efforts through a genuine partnership lens, with the aim of supporting improved high quality personcentred chronic pain care. Key targets identified included the need for training in empathic validation; effective, respectful, safe communication; and ensuring genuine partnerships in co-planning personalised care.
Declaration
This paper is from one project from a broader 4-year Australian Government funded consortium program on the development of interdisciplinary health professionals pain training programs. The consortium program is led by Professor Michael Nicholas (Pain Management Research Institute), Sydney University.
Thank you to APS member Michael Nicholas for sharing the following recent publication.
Article first published online: 19 April, 2022
Journal Reference: PAIN: www.painjournalonline.com
DOI: 10.1097/j.pain.0000000000002654
Abstract
Over the last 40 years the biopsychosocial model of pain has provided a unifying perspective and framework that has guided both research on pain and decisions about the treatment of pain. While evidence for the model has been broadly supportive and the model is still commonly referred to in the opening lines of texts and presentations on pain and pain management, it is not always clear how it has been used to inform treatments for pain. Some commentators have attributed this to a tendency for pain researchers and clinicians to work in isolated, specialised silos. Given these observations and the close to universal acceptance of the model, it would seem important to take stock of how it is being used in practice and whether we could be using it more effectively. This paper describes the development and supporting evidence for the biopsychosocial model of pain and examines the extent to which it is being used to inform treatments of pain in the peer-reviewed literature. While adherence to the model is evident in some areas, such as paediatric pain management and rehabilitation following work injuries, this is not so common generally. The implications of poor adherence to the model, particularly for treatment outcomes, are considered, together with the emerging calls and evidence for more comprehensive approaches to pain management. The paper concludes with a consideration of where we might go from here.
A narrative review of randomized controlled studies (RMT) studies included in recent systematic reviews of four types of treatments
for chronic pain: spinal cord stimulators, opioids, exercises, and psychological treatments.
Few treatment studies appeared to assess possible biological, psychological, and social/ environmental contributors to pain before treatment commenced, nor did many tailor the interventions accordingly. Inclusion criteria often seemed overly narrow, such as age, pain chronicity and site. Exclusion criteria were often related to mental health and drug use – common issues for people living with chronic pain. Treatments often seemed quite narrow in focus and disconnected from the contexts in which the participants experience their pain. However, some notable exceptions were identified, and more comprehensive treatments, based on the biopsychosocial model of pain, are increasingly common.
Failure to adhere to the tenets of the biopsychosocial model of pain could explain a proportion of the disappointing results from each of the treatment modalities studied. These failures appear to be related to the commonly observed tendency for clinicians/ researchers to limit their treatments to one modality. In general, clinicians and researchers are still to take up the challenge issued by Loeser in 1982 and subsequently reinforced by Vlaeyen, Morley and others, of determining which treatment works for which patients and under what circumstances. But there are signs this is changing, and there are useful clues for where we might go next.
Professor Nicholas receives royalties from a book for patients living with pain and this paper was prepared following the award of a prize from IASP for a plenary lecture to be presented at the forthcoming World Congress on Pain in Toronto in September.
Thank you to APS member Colleen JohnstonDevin and her colleagues Florin Oprescu, Marianne Wallis and Marion Gray for sharing the following recent publication.
Book first published online: 13 June 2022
Journal Reference: Johnston-Devin C, Oprescu F, Wallis M, Gray M (2022) Educational considerations for health professionals to effectively work with clients with complex regional pain syndrome. PLoS ONE 17(6): e0269337.
DOI: https://doi.org/10.1371/journal.pone.0269337
Abstract
Introduction
People living with complex regional pain syndrome (CRPS), a rare chronic pain disorder, must become experts in their own selfmanagement. Listening to the voice of the patient is often advocated in the pain literature. However, the patient’s opinion is rarely asked for or considered by clinicians, even when they live with a condition that health professionals have rarely heard of.
Purpose
To explore what people living with complex regional pain syndrome (CRPS) think health professionals should know about their condition to provide appropriate care.
Design
A heuristic, hermeneutic phenomenological study was conducted asking people about their experiences living with CRPS. This paper reports on the findings of an additional question asked of all participants.
Participants
Seventeen people living with complex regional pain syndrome were interviewed.
Findings
Overwhelmingly, participants felt that health professionals do not know enough about CRPS, or chronic pain and believe their health outcomes are affected by this lack of knowledge. Sub-themes identified were don’t touch unless I say it is okay; be patient with the patient / it is important to develop a
relationship; educate yourself and educate the patient; choose your words carefully and refer to others as needed. An additional theme, it is very hard to describe CRPS was also identified.
Including patients as a member of the healthcare team is recommended to help people take control and self-manage their pain. For true patient centered care to be achieved, health professionals must accept and respect patients’ descriptions of pain and their pain experience. This may require additional health professional education at both undergraduate and post-graduate levels in pain and communication to increase their bedside manner and therapeutic communication to deliver care in partnership with the patient.
Implications/Discussion
Participants in this research felt that health professionals need to learn/know that CRPS exists, believing that if their health professional knew more about the condition, they would not be disbelieved when they could not adequately describe their symptoms, pain levels and amount of suffering experienced. The view of some health professionals that chronic pain patients are untrustworthy, depressed, drugseeking or drug-abusing further increases the patient burden, compromises the patient/ clinician relationship and results in poor levels of care. Empathetic patient-centred care is known to be more forthcoming when patients have visible physical signs of pain such as in rheumatoid arthritis rather than conditions such as fibromyalgia. Health professionals working clinically are more likely than the general public to disbelieve people reporting chronic pain, and the higher the severity of the reported pain, the more likely it is to be discounted by clinicians. The physical signs of CRPS are known to reduce over time and some patients are therefore loath to display or disclose their pain levels.
Patients perceive their treatment to be effective and show reduced symptoms and improved recovery when they feel their health professional has a good ‘bedside manner’. Development of an empathetic bedside manner and provision of patient-
Educational considerations for health professionals to effectively work with clients with complex regional pain syndrome
centred care rely on basic health care skills and effective communication. A therapeutic alliance is required where there is no power differential between the patient and the health professional, use of a biopsychosocial perspective and respect for the patient as a person to achieve effective patient-centred care.
In cases where the cause of the pain is unknown, it is also important for primary practitioners to consider CRPS as a possible diagnosis and to refer patients to other
specialists, as necessary. The authors in this current study also suggest that implementation of the European Pain Federation standards for the diagnosis and management of complex regional pain syndrome worldwide could result in better referral practices for all patients with chronic pain.
Declaration
Johnston-Devin C, Oprescu F, Wallis M, and Gray M have nothing to declare.
Vital reference for both Residential and Community Aged Care settings.
2nd Edition
The gold standard in Pain Management for Older People is now available in eBook format!
In this edition:
Chapter 1: About Pain
Chapter 2: Identi cation and assessment of pain in aged care residents
Chapter 3: Beyond medication: psychological and educational approaches to pain management
Chapter 4: Movement and physical activity
Chapter 5: Complementary approaches to pain
Chapter 6: Pharmacological treatments
Chapter 7: Dementia and cognitive impairment: special considerations
Chapter 8: Pain at the end of life
Chapter 9: Pain and nutrition
Chapter 10: Quality and systems issues
Dr David Holloway is currently Director, electronic Persistent Pain Outcomes Collaboration (ePPOC), at the Australian Health Services Research Institute (AHSRI) at the University of Wollongong. David joined the APS on commencement of his current role in May 2022. For more on ePPOC see: https://www.uow. edu.au/ahsri/eppoc/
How did you get into pain research/clinician practice?
I’ve spent much of my career working in the areas of alcohol and other drugs nursing, chronic disease management, and quality and safety, so after finishing my PhD the opportunity to work for an outcomes collaboration focused on persistent pain outcomes and quality improvement seemed the ideal next step.
What does your current research or clinical practice focus on? Why is this important?
As an outcomes collaboration, ePPOC is about supporting member pain services with comprehensive benchmarking data to inform quality of care and outcomes improvement for people living with chronic pain. We conduct research ourselves (https://www.uow.edu.au/ ahsri/eppoc/publications/) and also support external research as appropriate.
What do you think will be the next “hot topic” in your area of research or practice?
With the scope of ePPOC’s data set, there’s a lot of opportunities to be explored. The impact of COVID-19 on services is one emerging area receiving a lot of interest, as is the impact of geography and socioeconomic disadvantage on access to services and related outcomes. Patient-reported outcome measures are another area of ongoing interest.
If you could offer one piece of advice to a younger you, what would it be and why?
Always keep reading, both professionally and personally. In a busy professional life, it’s understandable to put reading down the priority list for those day-to-day urgent activities but work it in however you can.
If you weren’t in the pain science field, what would you be doing?
Running a small bricks and mortar bookshop at a huge loss!
The Australian Pain Society (APS) is a multidisciplinary association whose purpose is to advance pain management through education, research, and advocacy for transformational improvements in clinical care. Our vision is that all people will have optimal pain management throughout life.
Cops for Kids (CFK) is a South Australian based charity focused on supporting initiatives that strive to improve the lives of children in that state. Part of the CFK mandate includes the provision of funds for research to assist in the care of sick children and/or enhance the life quality of a child.
APS is pleased to announce the sixth and final Clinical Research Grant in partnership with Cops for Kids.
In brief, the award is to enable clinical research meeting the following criteria:
> Approach a meaningful conclusion in one year
> Conducted in Australia and must be relevant to the South Australian population
> The applicant must be an Australian citizen or permanent resident
> The applicant and their supervisor (if applicable) must be members of the Australian Pain Society and its Pain in Childhood Special Interest Group
> The funded project can be related to any aspect of a childhood pain complaint - including theoretical, mechanistic, diagnostic, treatment, epidemiological and/or sociological approaches; and
> The grant funding (inclusive of GST) will be paid quarterly in arrears upon the submission and acceptance of a combined Progress Report-Acquittal Form
Further information about the Clinical Research Grant can be obtained from the APS Secretariat.
Clinical Research Grant Application forms are available online and must be submitted by: 5pm on Tuesday 27 September 2022.
Activity now seen as key to relief from low back pain
Australia has a new clinical care standard for low back pain, a condition which affects one in six Australians and is a leading cause of lost work productivity and early retirement.
Australia has a new clinical care standard for low back pain, a condition which affects one in six Australians and is a leading cause of lost work productivity and early retirement.
While back pain can sometimes have a serious cause, the vast majority of people can improve their pain with simple measures. Interventions such as imaging and high-risk medicines can usually be avoided.
Developed by the Australian Commission on Safety and Quality in Health Care, the Low Back Pain Clinical Care Standard recommends active approaches and individualised care to support the millions of Australians with low back pain.
Developed by the Australian Commission on Safety and Quality in Health Care, the Low Back Pain Clinical Care Standard recommends active approaches and individualised care to support the millions of Australians with low back pain.
The Low Back Pain Clinical Care Standard will improve the early assessment and management of patients with low back pain, so that people receive the most appropriate treatment for their individual circumstances.
The new standard provides a road map for healthcare practitioners to help patients manage low back pain episodes early and reduce their chance of ongoing problems.
The new standard provides a road map for healthcare practitioners to help patients manage low back pain episodes early and reduce their chance of ongoing problems.
Most people will experience low back pain at some point in their life. Back problems are one of the most common reasons Australians visit their GP or present to the emergency department.
Most people will experience low back pain at some point in their life. Back problems are one of the most common reasons Australians visit their GP or present to the emergency department.
Recommendations include selfmanagement and physical activity, addressing psychological barriers to recovery such as thoughts and emotions about pain, as well as tackling social obstacles, including work and home stress.
While back pain can sometimes have a serious cause, the vast majority of people can improve their pain with simple measures. Interventions such as imaging and high-risk medicines can usually be avoided.
To find out more about the standard, view the expert panel discussion and download resources, visit: safetyandquality.gov.au/ lowbackpain-ccs
The Low Back Pain Clinical Care Standard will improve the early assessment and management of patients with low back pain, so that people receive the most appropriate treatment for their individual circumstances.
Recommendations include self-management and physical activity, addressing psychological barriers to recovery such as thoughts and emotions about pain, as well as tackling social obstacles, including work and home stress.
To find out more about the standard, view the expert panel discussion and download resources, visit: safetyandquality.gov.au/lowbackpain-ccs
13-17 November 2022
Novotel Barossa Valley, South Australia Applications Open: 17 May 2022
www.dcconferences.com.au/painstar2022
> Low Back Pain Clinical Care Standard launched by Australian Commission on Safety and Quality in Health Care on 01SEP22: https://www.safetyandquality.gov.au/ standards/clinical-care-standards/low-backpain-clinical-care-standard
> Latest opioid data from the Australian Bureau of Statistics: Opioid induced deaths in Australia. https://www.abs.gov.au/ articles/opioid-induced-deaths-australia
> Australia’s annual overdose report 2019 from the Pennington institute : http:// www.penington.org.au/australias-annualoverdose-report-2019/
> The Third Australian Atlas of Healthcare Variation: This series explores how healthcare use in Australia varies depending on where people live. It investigates reasons for variation that may be unwarranted, and provides specific achievable actions to reduce unwarranted variation. https://www.safetyandquality.gov.au/atlas
> Painaustralia eNewsletter latest issue, available online at http://www.painaustralia. org.au/media/enews
> ePPOC: electronic Persistent Pain Outcomes Collaboration: The electronic Persistent Pain Outcomes Collaboration (ePPOC) is an Australasian initiative that aims to improve the quality of care and outcomes for people who experience chronic pain. For more information about ePPOC, refer to the website: http://ahsri. uow.edu.au/eppoc/index.html
> PainHEALTH website: painHEALTH‘s aim is to help health consumers with musculoskeletal pain access reliable, evidence-based information and tips to assist
in the co-management of musculoskeletal pain. painHEALTH is an initiative of the Department of Health, Western Australia. http://painhealth.csse.uwa.edu.au/
> Stanford University: CHOIR Collaborative Health Outcomes Information Registry https://choir.stanford.edu/
> Opioid Podcasts for GPs: These podcasts are produced by David Outridge GP, and FAChAM Trainee as a project under the auspices of Dr Steven Kelly Staff Specialist in Addiction Medicine, Kullaroo Clinic Gosford. A 20 week series from the Hunter Postgraduate Medical Institute (University of Newcastle) : http://www.gptraining.com.au/ recent-podcasts
> Airing Pain: Pain resources via an online radio show produced by Pain Concern, a UK registered Charity: http://painconcern.org.uk/ airing-pain/
> Digital Health Guide: Developed by Primary Health Network Tasmania, check out the pain resources by accessing the link https:// digitalhealthguide.com.au/Account/LogOn? ReturnUrl=%2fSpecialtyFormulary%2f2 At login, Username: connectingcare, Password: health
> Indigenous Resources: New webpage on the APS website aggregating Indigenous resources: https://www.apsoc.org.au/
Indigenous-Resources
NPS MedicineWise resources:
> Choosing Wisely Australia – News & media: https://www.choosingwisely.org.au/ news-events/media-releases/choosingwisely-resource-addresses-patient-opioidknowledge-gap
> Over the counter codeine – changes to supply: https://www.nps.org.au/medical-info/ clinical-topics/over-the-counter-codeinechanges-to-supply
> Medicines with codeine – what you need to know: https://www.nps.org.au/medical-info/ consumer-info/medicines-with-codeinewhat-you-need-to-know
> Information about opioids and chronic noncancer pain: U-tube clip (5.39mins) https:// www.youtube.com/watch?v=8R4RT0pUCf 4&feature=share&fbclid=IwAR2dbhzgEAcc 7B-ogq2a6Xhud5FDkbciPbdJ9pb94GnQI6p AeifGd1VP-_I
> Opioids: Communications videos: https:// www.nps.org.au/opioids-communication-videos
TGA
> Codeine information hub: https://www.tga. gov.au/codeine-info-hub
> Brainman and Pain Tool Kit translations, SEP15: http://www.aci.health.nsw.gov.au/
chronic-pain/translated-resources
> Pain Management Resources: https:// aci.health.nsw.gov.au/networks/painmanagement/resources
> Quicksteps to Manage Chronic Pain in Primary Care: http://www.aci.health.nsw. gov.au/chronic-pain/health-professionals/ quick-steps-to-manage-chronic-pain-inprimary-care
> Built into Quicksteps: “How to de-prescribe and wean opioids in general practice”: http:// www.aci.health.nsw.gov.au/chronic-pain/healthprofessionals/quick-steps-to-manage-chronicpain-in-primary-care/how_to_de-prescribe_and_ wean_opioids_in_general_practice
> A list of helpful apps for consumers and clinicians now available at: http://www.aci. health.nsw.gov.au/chronic-pain/healthprofessionals/management-of-chronic-pain
> Chronic Pain in the ED: https://www.aci. health.nsw.gov.au/networks/eci/clinical/ clinical-resources/clinical-tools/pain-
New Members as at 25 August 2022:
Dr
Elizabeth Chye AnaesthesiaMiss Jerodine Kamunde Nursing
1-4 September 2022
ANZSPM 2022
Better Care For All: Inclusivity, Equity and Collaboration
Hotel Realm, Canberra, ACT
https://willorganise.eventsair.com/2022-anzspm/
14-17 September 2022
Wounds Australia 2022 Conference Time to Heal, Time to Unite, Time to Innovate ICC, Sydney, NSW
http://wounds2022.com.au/home
6 October 2022
RECOVER Conference 2022
Optimising patient care: from interpersonal to digital connections
Sofitel Brisbane Central, Brisbane, QLD
https://recover.centre.uq.edu.au/
14-16 October 2022
Faculty of Pain Medicine (FPM)
2022 FPM Spring Meeting
Peppers Noosa Resort & Villas, Noosa, QLD
https://www.anzca.edu.au/events-courses/ events/major-events/fpm-national-events/2022fpm-spring-meeting
21-24 October 2022
NZSA & ASA Combined Scientific Congress 2022
Jointly hosted by the New Zealand Society of Anaesthetists (NZSA) and the Australian Society of Anaesthetists (ASA)
TSB Arena, Wellington, NZ
https://www.csc2022.co.nz/
13-17 November 2022
Australian Pain Society
painSTAR - Pain School for Translation And Research
Novotel Barossa Valley, Adelaide Hills, SA
https://dcconferences.eventsair.com/painstar
15-16 November 2022
National Rural & Remote Allied Health SARRAH Conference 2022
People, Purpose, Passion: Pathways to Success
Virtual, Online Conference
https://sarrahconference.com.au/
25-27 November 2022
RACGP GP22
Melbourne Convention & Exhibition Centre, Melbourne, VIC
https://www.racgp.org.au/gp22/gp22-home
23-26 March 2023
New Zealand Pain Society
NZPS 2023 “Designing a Better Future”
The Cordis Hotel, Auckland, NZ
https://www.nzps2023.nz/
2-5 April 2023
Australian Pain Society
APS 2023 43rd Annual Scientific Meeting
National Convention Centre, Canberra, ACT
https://www.dcconferences.com.au/aps2023/
10-13 September 2023
10-13 September 2023
Diversity and Leadership
Hotel Grand Chancellor, Hobart, TAS
https://www.dcconferences.com.au/rmsanz2023/ home
20-23 September 2023
European Pain Federation EFIC 13th Congress
Personalised Pain Management: The future is now
Budapest, Hungary
https://europeanpainfederation.eu/efic2023/
Vision:
All people will have optimal pain management throughout life.
Purpose:
The Australian Pain Society is a multidisciplinary association whose purpose is to advance pain management through education, research, and advocacy for transformational improvements in clinical care.
Priorities:
In order to achieve our purpose, the Australian Pain Society will provide:
> Membership
> Research
> Education
> Services and resources
> Good governance and operations
> Advocacy
President:
Ms Trudy Maunsell
Acute Pain Service
Princess Alexandra Hospital
Woolloongabba QLD 4102
Tel: 07 3176 5547 Fax: 07 3176 5102
President-Elect:
Mrs Joyce McSwan
Gold Coast Primary Health Network
Persistent Pain Program, QLD and PainWISE
Tel: 0412 327 795 Fax: 07 3539 9801
Secretary:
Mrs Dinah Spratt
Physiotas Physiotherapy
Shearwater TAS 7307
Tel: 03 6428 7500 Fax: 03 6424 7811
Treasurer
Dr Laura Prendergast
Pain Service, Northern Health
Broadmeadows VIC 3047
Tel: TBA Fax: N/A
ACT Director:
Dr Andrew Watson
Calvary Hospital
Canberra ACT 2617
Tel: 02 6201 6352 Fax: N/A
NSW Director:
Dr Tim Ho
Inner West Pain Centre
RPA Medical Centre
Newtown NSW 2042
Tel: 02 9517 1764 Fax: 02 9517 1832
NT Director: TBA
Currently vacant, please contact the APS Secretariat with your expression of interest - aps@apsoc.org.au
QLD Director:
Mrs Karalyn Huxhagen
KH Pharmacy Consulting
Mackay QLD 4740
Tel: 0418 185 972 Fax: 07 4805 6155
SA Director:
Dr Michelle Harris
Royal Adelaide Hospital and Lyell McEwin Hospital
Adelaide SA
Email: michelle.harris2@sa.gov.au
TAS Director:
Ms Bernadette Smith
Psychology Plus
South Burnie TAS
Tel: 03 6431 9959 Fax: 03 6431 9950
VIC Director:
Dr Esther Dube
Austin Health Heidelberg VIC 3084
Tel: New VIC members please contact
Dinah Spratt – Secretary Fax: N/A
WA Director:
Ms Jacintha Bell
Lifeworks Occupational Therapy
Subiaco WA 6008
Tel: 0451 178 880 Fax: 08 6323 3329
Immediate Past President:
A/Prof Anne Burke
Central Adelaide Local Health Network
Royal Adelaide Hospital
Adelaide SA 5000
Tel: 08 7074 2835 Fax: 08 7074 6247
SPC Chair:
Professor Kevin Keay
Department of Anatomy
University of Sydney
Sydney NSW 2006
Tel: 02 9351 4132 Fax: 02 9351 2817
IASP Liaison:
Professor Michele Sterling
Recovery Injury Research Centre
University of Queensland
Herston QLD 4092
Tel: 07 3346 4793
Communications Coordinator:
Ms Trudy Maunsell
Acute Pain Service
Princess Alexandra Hospital
Woolloongabba QLD 4102
Tel: 07 3176 5547 Fax: 07 3176 5102
Newsletter Editor:
Dr Lincoln Tracy
School of Public Health and Preventive Medicine
Monash University
Melbourne VIC 3004
Tel: 03 9903 0288
Newsletter Assistant Editor:
Dr Joanne Harmon
School of Clinical and Health Sciences
University of South Australia
Adelaide SA 5000
Tel: 08 8302 1442
Scholarship/Grant Selection Subcommittee Chair:
Dr Michael Farrell
Retired VIC Secretariat:
DC Conference & Association
Management Pty Ltd
PO Box 637
North Sydney, NSW 2059
Tel: 02 9016 4343
Email: aps@apsoc.org.au
Website: apsoc.org.au
