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Management of pain

Current research projects 2017

General practitioners, patients, and conversations about chronic pain

PI: Dr Lee Thompson ( Department of Population Health, University of Otago, Christchurch)
Funder: University of Otago Research Grant - 2017-2018
Collaborators: Researchers: Dr Maria Stubbe, Jo Hilder, Rachel Tester, Dr John Alchin, Professor Tony Dowell.

Little is known about how GPs and patients discuss and manage persistent pain. Analysing existing video recordings of primary care consultations, this project will investigate how GPs and patients in the UK and New Zealand discuss chronic pain. Chronic pain is complex and often misunderstood. This research will provide a much deeper understanding of how such misunderstandings might be produced and reproduced in primary care consultations. It has the potential to highlight areas for intervention, which in turn will lead to more effective management of chronic pain. The new understandings generated will translate to public education and health promotion, clinical training and clinical practice.

Burwood Assessment, Screening and Education for Chronic Pain: An evaluation

Summer studentship research 2016-2017
PI: Dr Lee Thompson (Department of Population Health, University of Otago, Christchurch)
Funder: New Zealand Federation of Graduate Women
Collaborators: Dr John Alchin, Bronny Trewin, Maddie Jordan Weston (Student)

The Burwood Pain Management Service in Christchurch has developed an innovative pilot programme, Burwood Assesment Screening and Education (BASE) which involves offering a half day group programme of education and basic self-management principles for all appropriate referrals. The goal of BASE is to not only have many more people exposed to the principles of pain management, but to provide more comprehensive and appropriate data for triage into CPA. Process evaluation questionnaires have been completed by patients as they complete the BASE programme.
The research project was designed to analyse the first six months of data from BASE process evaluation questionnaires.
Findings from this studentship project will provide interim data on the extent to which the programme is acceptable and effective in increasing patient self-reported understanding of the mechanisms of chronic pain, fostering acceptance of chronicity, and openness to self-management. These findings will be used to modify the programme as appropriate. A report for the Canterbury District Health Board is being finalized.

Pain in Childbirth: predictors, correlates, outcome and management

PI: Dr Nicola Swain
Funder: Pain@Otago Small Project Award 2016

Pain in childbirth receives little research attention. Although it may be seen as a biological imperative, pain experienced in childbirth is a predictable acute pain episode that should be able to be well managed. Just like initial reluctance to use anesthesia in surgery, there seems some opinion that childbirth pain should be tolerated rather than treated. A sample of 137 first time mothers were recruited. They were questioned 4 times: around 24 weeks gestation, pre-birth, post-birth and six month post-partum. Expectations of pain were rated and this was found to have a weak positive correlation with pain experienced.

Updates from Nicola on her project:

I recently was lucky enough to gain a small project funding grant from Pain@Otago. I used this money to employ an amazing graduate student Lana. Lana took some pain data that we had collected as part of another project about childbirth satisfaction and analysed it. The data was quite complex and she consulted a biostatistician and made statistical models of what predicted childbirth pain and what outcomes it led to. I took the results to a Behavioural Medicine conference in San Diego earlier this year, where it was well received. I'm busy creating a final draft to submit to a journal. Thanks Pain@Otago!

Nortriptyline in Knee Arthritis - NortIKA

PI:  Dr Ben Hudson
Funder: Health Research Council

Nortriptyline (an antidepressant) has been used to treat persistent pain in other conditions, and other antidepressants may reduce pain in knee OA. It is not known whether nortriptyline is useful in this condition. For more about the project visit the study web page.

A neuroscience pain education approach as management of patients with persistent shoulder pain/rotator cuff syndrome.

PI: Dr Gisela Sole
Funder:  Physiotherapy New Zealand, and New Zealand Manipulative Physiotherapist Association

Shoulder pain associated with rotator cuff syndrome (sub-acromial pain syndrome) is common in middle-aged and older adults, often leading to long term shoulder pain, stiffness and weakness, and limitations in terms of self-care, physical activity, and work-related tasks. Rehabilitation guidelines for rotator cuff syndrome have generally focused on potential pathology and impairment of local shoulder structures (“local pathology model”). However, changes in the nervous system, including the brain, also contribute towards the pain experience.

Outputs for 2017

Gillespie M, Mącznik A, Wassinger C, Sole G (2017). Rotator cuff-related pain: patients’ understanding and experiences. Musculoskeletal Science and Practice 30:64-71 (Impact factor 2.158)
Member of an international Focused Symposium on rotator cuff tendinopathy/syndrome at the World Confederation of Physical Therapy (WCPT) in Cape Town, July 2017. 
2017 Honours student: Karen Meehan: Education for patients with persistent rotator cuff-related pain: a scoping review and physiotherapist focus group

Ageing well with chronic pain

PI: Prof David Baxter
Funder:  Lottery Health New Zealand

Our study will bridge an important gap between what is known about pain, and pain-related impact on activity restrictions and social participation in the ageing population. For more about the study and our team visit our study page.

Graduate student research

  • Focus groups to understand the obstacles and facilitators to physiotherapists integrating psychosocial factors in their assessments - MHealSc project lead by Dr Bronwyn Thompson
  • Project focusing on assessment of central sensitization in clinical practice, and professional education requirements. - PhD Student Abdullah Alqarni.  Ram Mani (lead supervisor), co-supervisor Steve Tumilty and David Baxter

Project underway looking at experience of chronic pain in USA, focusing on experience of disadvantaged communities and undocumented patients. - PhD student Alicia Emerson (Overseas-based Student). David Baxter (lead supervisor) Co-supervised with Ram Mani.

Group members

Prof Dirk de Ridder (Department of Surgical Sciences, Dunedin School of Medicine)
Prof David Baxter (School of Physiotherapy)
Prof Mauro Farella (School of Dentistry)
Dr Steve Tumilty (School of Physiotherapy)
Dr Ramakrishnan Mani (School of Physiotherapy)
Dr Cathy Chapple (School of Physiotherapy)
Dr Mavis Duncanson (Department of Women’s and Children’s Health, Dunedin School of Medicine)
Dr Nicola Swain (Psychological Medicine, Dunedin School of Medicine)
Dr Bronwyn Thompson (Department of Orthopaedic Surgery & Musculoskeletal Medicine, Christchurch)
Dr Ben Hudson (General Practice Research Group, Christchurch
Dr Phillippa Seaton (Centre for Postgraduate Nursing Studies, Christchurch)
Dr Gisela Sole (School of Physiotherapy)
Dr Gareth Treharne (Department of Psychology)


Management of pain sub-theme is led by Prof Dirk de Ridder.

For further information about the sub-theme: