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2022 Australian Pain Society 42nd Annual Scientific Meeting

2022 Australian Pain Society 42nd Annual Scientific MeetingIn the IASP Global Year for Translating Pain Knowledge to Practice10 - 13 April 2022 | Hotel Grand Chancellor, Hobart TAS

Topical Sessions

Please click below for session outlines and confirmed speakers

Topical Sessions 1 - Monday 11 April 2022, 10.45 am - 12.15 pm

Topical Sessions 2 - Monday 11 April 2022, 1.45 pm - 3.15 pm

Topical Sessions 3 - Tuesday 12 April 2022, 11.00 am – 12.30 pm

Topical Sessions 1
Monday 11 April 2022, 10.45 am - 12.15 pm

1A: Placebo and nocebo from the lab to the hospital: State of the field and implementing procedures to drive therapeutic benefits
Chair: Damien Boorman, University Of Sydney, NSW

This session will be split into two parts. First, five early and mid-career researchers will briefly summarise the key findings from their specific research fields. Dr Kirsten Barnes will discuss what we have learned about placebo and nocebo effects in experimental settings, including her latest work with virtual reality. Lewis Crawford will outline the specific brain circuitry shown to be involved in placebo and nocebo responses from human imaging studies. Damien Boorman will consider the utility of preclinical models to help discover the neural mechanisms of placebo and nocebo effects as well as trial novel treatment approaches. Dr Natalia Egorova Brumley will explore how observational learning can influence an individual’s placebo and nocebo responses, and Dr Felicity Braithwaite will discuss ethical, evidence-based strategies to harness the benefits of placebo responses in clinical practice. The second part of this session will involve an interactive discussion with our panel members. Here, the audience will have the opportunity to experience a live placebo demonstration, and to participate in crafting patient-clinician interactions designed to maximise placebo and minimise nocebo. Please come ready to share your experiences and insights and help us shape the future of placebo and nocebo research!

Damien Boorman, University Of Sydney, NSW
Dr Kirsten Barnes, University Of Sydney, NSW
Lewis Crawford, University Of Sydney, NSW
Dr Natalia Egorova Brumley, University of Melbourne, VIC
Dr Felicity Braithwaite, University of South Australia, SA

1B: New Opportunities: Maximising impact of the acute pain round
Chair: Dr Andrew Watson, Calvary Public Hospital/ Canberra Hospital Health Service, ACT

The role of the traditional post-surgical inpatient acute pain round is rapidly evolving. This session reviews three highly topical areas - prehabilitation, transitional pain and a review of procedures to consider in this setting - and has three excellent speakers. There is increased awareness of the huge incidence of chronic pain in the hospitals, its enormous impact in terms of suffering, length of stay and cost, and growing interest in the role an expanded pain service can have in addressing all of these for both surgical and medical inpatients.

Professor Claire Ashton-James will review and explore prehabilitation, focusing on heart research and strategies to prepare people with chronic pain for upcoming surgical procedures.  Dr Guy Buchanan from Victoria co-convened the excellent 2021 FPM/ANZCA ASM pain programme and will review key procedures to consider for the medical patient with poorly controlled chronic pain. Dr Michelle Harris is the state director of the APS from South Australia and also its representative for the FPM and will review one of her areas of interest - the rapidly expanding field of transitional pain services which is designed to intercept people on their pain journey.

Dr Claire Ashton-James, University of Sydney, NSW
Dr Guy Buchanan, Metro Pain, VIC
Dr Michelle Harris, Royal Adelaide Hospital, SA

1C: Treating Chronic Pain From A Neurobiological Perspective
Chair: Professor Lorimer Moseley, University of South Australia, SA

Over the past 10 years, systematic reviews and randomised controlled trials have found that most common management strategies (e.g., drugs, surgery, acupuncture, etc.) for chronic pain do not provide clinically meaningful reductions in pain or disability and may do severe harm. There is an urgent need to identify alternative approaches to managing chronic pain.

Research investigating the contribution of altered neural processing to the chronic pain experience has suggested novel treatment approaches for people with chronic pain. Interventions thought to target central nervous system function – conceptual change reinforced with graded sensory and movement programmes – may offer clinically meaningful reductions in pain intensity for adults with chronic pain.

Consistent with this approach, our group developed a novel education and graded sensorimotor retraining program, RESOLVE, that employs a framework informed by pain science that directly targets how people think about their body in pain, how the painful area feels to them and how they move and load the painful area.

We will present new data on novel treatment strategies to target central nervous system function for people with chronic pain. This will appeal to both clinicians and researchers keen on providing treatments which better align with the biopsychosocial nature of chronic pain.

Professor James McAuley, University of NSW, NSW
Professor Lorimer Moseley, University of South Australia, SA
Dr Aidan Cashin, Neuroscience Research Australia, NSW

1D: Formulating self-management strategies for persistent pain conditions
Chairs: A/Prof Tasha Stanton, IIMPACT in Health, Allied Health and Human Performance, SA

This session will facilitate clinicians' providing clear and consistent pain information to their patients in keeping with the patients' attitude; this could, in turn, remove barriers to self-management. We will also consider the challenges of delivering effective educational interventions and in socio-economically disadvantaged settings and suggest how clinicians may be able to adapt care strategies to better meet the needs of those at risk of the poorest outcomes.

Pain education interventions consist of target concepts. The majority of these have been developed in a “top-down” manner, relying largely on conceptual models and formulated by clinicians and researchers. We provide a “bottom up” approach, by establishing which target concepts in pain education interventions are most important to those who live well with persistent pain.

Understanding patient attitudes towards pain education could help clinicians provide effective patient education. Evaluating attitudes toward pain education that reflect self-management behaviours could help prioritise which messages are provided in clinical consultations.

Particular challenges arise when providing pain care for people from disadvantaged settings – educational interventions are frequently ineffective. This session will provide insights into the role of social determinants of health in persistent pain and discuss the need to consider health equity to reduce the burden of persistent pain.

Edel O'Hagan, Centre For Pain IMPACT, Neuroscience Research Australia, NSW
Hayley Leake, Centre For Pain IMPACT, Neuroscience Research Australia, NSW
Dr Emma Karran, IIMPACT in Health, Allied Health and Human Performance, SA

1E: The National Pain Management Education Strategy for Health Practitioners - Translating strategy into action
Chair: A/Professor Meredith Craigie, The Queen Elizabeth Hospital, SA

It is essential that health professionals are well supported by quality pain management education during entry-to-practice programs, and throughout their careers, to ensure the delivery of high quality, evidence-based care, and optimum health outcomes for the community. 

The Faculty of Pain Medicine, ANZCA, with funding from the Australian Government Department of Health, embarked on a project in 2020 to develop a national strategy for pain management education.  The strategy addresses a key priority within the National Strategic Action Plan for Pain Management and provides a high level ‘roadmap’ for developing and delivering pain management education across health disciplines for the next 5 – 10 years.

The final strategy is the result of an in-depth literature review and extensive stakeholder consultation which encompassed a broad range of health disciplines and included participants from across Australia.  There was special attention paid to ensuring the voices of rural and remote, indigenous, and culturally and linguistically diverse communities were captured and incorporated.

This workshop will provide participants with an early preview of the final strategy and an opportunity to workshop with other health professional educators, from a range of discipline areas, in considering how it can be translated into practice in their own educational environment.

A/Professor Michael Vagg, Pain Matrix, VIC
Leone English, Faculty of Pain Medicine, VIC

1F: Caring for our older adults – A multidisciplinary update on pain in the elderly
Chair: Trudy Maunsell, Princess Alexandra Hospital, QLD

This topical session will provide the you with an update on the management of pain in the older adult. You will refresh your skills in the assessment and management of pain in clients with delirium and dementia, know what pharmacological and non-pharmacological interventions to use when caring for our older clients and examine the evidence base behind current and potential physiotherapy interventions to promote mobility and function for those in residential aged care facilities.

Dr Frederick Graham, Princess Alexandra Hospital, QLD
Ms Karalyn Hushagen, KH Pharmacy Consulting, QLD
Dr Emre Ilhan, Macquarie University, NSW

Topical Sessions 2
Monday 11 April 2022, 1.45 pm - 3.15 pm

2A: Exploring the use of innovative technology for the assessment and treatment of pain
Chair: A/Professor Tasha Stanton, University of South Australia, SA

Emerging technologies, such as virtual reality and brain-computer interfaces, are creating new possibilities for assessing and treating pain. This session will explore exciting new research findings from Australian leaders in the pain-technology nexus, spanning virtual reality to brain-computer interfaces to telehealth. Importantly, this session will also have an interactive component providing you the opportunity to experience these technologies yourself!

Dr Dan Harvie will begin by presenting his work exploring the use of virtual reality as a novel means of both assessment and treatment in chronic pain. He will share new data on the use of VR to reduce pain evoked by visually-simulated touch in complex regional pain syndrome as well as the potential benefits of virtual body swapping in people with chronic back pain.

A/Prof Sylvia Gustin will then discuss her recent work exploring the therapeutic benefit of neuromodulation and of immersive VR in people with chronic neuropathic pain. She will also discuss findings supporting the use of internet-delivered psychological treatment that incorporates emotional skills training. Following a question and answer period, participants will have a chance to try out the programs discussed, as well as take part in other brain-bending experiences, such as the rubber hand illusion.

Dr Daniel Harvie, Menzies Health Institute Queensland, Griffith University, QLD
A/Professor Sylvia Gustin, University of New South Wales and Neuroscience Research Australia, NSW
Dr Negin Hesam-Shariati, University of New South Wales and Neuroscience Research Australia, NSW
Mrs Nell Norman-Nott, University of New South Wales and Neuroscience Research Australia, NSW 

2B: Mechanisms and management of osteoarthritis pain: Insights from studies using animal models of osteoarthritis
Chair: A/Professor Jason Ivanusic, University Of Melbourne, VIC

Osteoarthritis (OA) is a chronic condition of the joints and underlying bone characterized by swelling, stiffness and pain. While the focus on finding treatments for OA has been on stopping or slowing disease progression, we can make significant improvements to quality of life and economic burden by treating the underlying pain. Identifying new pain targets and translating them into treatments for OA pain is critical to improving quality of life for patients with OA.

In this topical session, presenters will share insights from studies that have used animal models to identify mechanisms of OA pain, and test different approaches to managing it. They will also contribute to a panel session that will discuss more broadly the strengths and limitations of using animal models to study OA pain.

A/Professor Jason Ivanusic, University Of Melbourne, VIC
A/Professor Wendy Imlach, Monash University, VIC
Dr Sanaa Zaki, University of Sydney, NSW                

2C: Promotion of coping in children from everyday to persistent pains
Chair: Dr Mark Alcock, Queensland Children's Hospital, QLD

Children's everyday/minor pain experiences can be affected by parental pain experiences and reactions, and this influences the development of children's understanding of and behaviours to minor injury. Researchers at University of South Australia report on the findings of a Delphi study to establish an expert consensus on the key messages and communication strategies for children of different ages that will help them understand pain, injury and promotes recovery and resilience to these everyday experiences at different age groups.

In our hospitals and clinics, infants and children continue to experience procedural pain as a result of their healthcare needs. In the second part of this session we will review practical evidence-based options to reduce the pain and promote coping associated with painful procedures in children

In the final section we will discuss Comfort-Ability, a brief cognitive behavioural therapy intervention, initially developed at Boston Children’s Hospital, and now being delivered at the Perth Children’s Hospital and Adelaide Women and Children’s Hospital both in-person and by telehealth formats. Clinicians will describe their early experience of developing and delivering this program for the Australian system which aims to promote positive coping strategies for those children with persistent pain.

Dr Sarah Wallwork, University of South Australia, SA
Dr Dianne Crellin, Royal Children's Hospital, VIC
Ms Anna Hilyard, Perth Children's Hospital, WA
Tegan Starr, Women & Children’s Hospital, SA

2D: Brain Biomarkers and clinical characteristics of chronic headache and migraine – Translating  knowledge of neuroscience and clinical presentation of chronic headache to clinical practice
Chair: A/Professor Trudy Rebbeck, University of Sydney, NSW

The global burden of disease study urged future research to focus on understanding new mechanisms that explain chronic headache persistence and treatment responsiveness. In this session we bring together a team comprising a neuroscientist, biochemist/ MR physicist together with our clinician – researcher physiotherapists. We will discuss our recent studies that have investigated; i) brain biomarkers using advanced neuroimaging (fMRI and MRS) and ii) clinical characteristics (neck muscle function and pain sensitivity) and their association with headache persistence and recovery. Discussion and examples of how this knowledge can be translated into clinical practise will be provided using case studies. The session will conclude with a panel discussion.

A/Prof Trudy Rebbeck (specialist musculoskeletal physiotherapist) will provide a brief overview of chronic headache and migraine and introduction of case studies to flow through the session.

Prof Luke Henderson (neuroscientist) will discuss work in advanced neuroimaging and evidence of brain changes, consistent with the hypothesis that endogenous analgesic circuits changes, are critical for migraine generation. 

Prof Graham Galloway (biochemist and MR physicist ) will discuss neurospectroscopy which offers a window into the biochemical tissue profile, to identify aberrant neurochemistry.  Elevated GABA+ in patients experiencing chronic pain, including migraine and level variations may allow stratification to identify responders to new therapies.

Dr Julia Treleaven (musculoskeletal physiotherapist) will present on the clinical characteristics and how to identify different causes of neck pain in migraine.  Together with neuroscience outcomes this knowledge may facilitate understanding of different mechanisms of neck pain in recurrent headache.

To close the session A/Prof Trudy Rebbeck will summarise the relationship between brain neurochemistry and clinical characteristics and provide real examples of clinical translation in the management of chronic headache.

The session will end with a 30 minute interactive panel discussion regarding the future to help identify treatment responders and/ or understand central and peripheral drivers of the headache experience.

A/Prof Trudy Rebbeck, University of Sydney, NSW
Professor Luke Henderson, University of Sydney, NSW
Professor Graham Galloway, University of Queensland, QLD
Dr Julia Treleaven, University of Queensland, QLD

2E: Diagnosis, management and lived experience of Complex Regional Pain Syndrome
Chair: Professor Lorimer Moseley, University of South Australia, SA

In recent years, research into Complex Regional Pain Syndrome (CRPS) has grown considerably, however, uncertainties surrounding its presentation, management and lived experience remain. Our recent research aims to resolve these ambiguities.

The challenges in treating CRPS are widely recognised. A broad range of pharmacological, physical and psychological treatments are used, and a multimodal approach is endorsed by clinical guidelines. Despite these recommendations, there are no interventions supported by high-quality evidence. Our research reviews the evidence for all interventions for CRPS to provide an updated framework for its management.

However, what CRPS patients think about treatments, advice and management has received remarkably little attention. These perspectives are of critical importance - as clinicians and researchers, we must prioritise patient perspectives and negotiate the tricky path between evidence for, and popularity of, different treatments. We have investigated what people with CRPS value in their treatments and the web-availability of information and advice about CRPS that is consistent with guidelines.

Our session will present an overview of all interventions for CRPS, outline a contemporary framework for its diagnosis and treatment, and explore the information people with CRPS can readily access and what they think is important in its management.

Michael Ferraro, Neuroscience Research Australia, NSW
Professor Eric Visser, University of Notre Dame Australia, WA
Emily Moore, University of South Australia, SA

2F: Clinical Stream: Multidisciplinary Assessment: A Management Example
Chair: Dinah Spratt, Physiotas, TAS

The APS is delighted to showcase its first Clinical Stream Topical Session at the Hobart ASM. The multi-disciplinary team from Hobart’s Persistent Pain Service session will provide delegates with an example of best-practice assessment methods used by the doctor, physiotherapist and psychologist, for a typical complex chronic pain patient example. They will demonstrate how they address the biopsychosocial components of the patient pain experience in establishing optimum patient-centred care, using team discussion and patient engagement.

Dr Hilton Francis, Persistent Pain Service, TAS
Michelle Wilson, Persistent Pain Service, TAS
Helen Pryer, Persistent Pain Service, TAS

Topical Sessions 3
Tuesday 12 April 2022, 11.00 am - 12.30 pm 

3A: How (and how well) does pain-related education work? Balancing pragmatism with the rigor of shams
Chair: Dr Joshua Pate, University of Technology Sydney, NSW

What is the appropriate amount of enthusiasm we should have for pain-related education based on the available evidence and resources? Research into pain-related education is rapidly accelerating. Comparisons between different types of educational interventions (e.g. ‘real vs placebo’ pain science education) and also between iterations of educational resources (e.g. version 1 vs version 5) are complex and challenging to conduct.

In this session, each speaker will unravel different challenges in pain-related education: Dr Adrian Traeger will explore the development of an ideal educational control group in a research trial of acute low back pain; A/Prof Tasha Stanton will discuss the use of a non-education sham control to account for therapist time/attention used in a feasibility study of painful knee osteoarthritis; Dave Moen will explore an iterative approach to educational resource development in chronic pain; and Dr Joshua Pate will explore how participants can be ‘their own control’ in a Single Case Experimental Design (SCED) study evaluating educational children’s books compared to sham.

At the end of the session there will be a Q&A discussing how well pain-related education works and how to best balance rigor with pragmatism in future projects, so that truly effective (and excellent) resources are developed to facilitate optimal patient outcomes.

Dr Adrian Traeger, University of Sydney, NSW
A/Prof Tasha Stanton, University of South Australia, SA
Dave Moen, Form Physiotherapy, SA

3B: Pain in Multiple Sclerosis
Chair: A/Professor Gila Moalem-Taylor, University Of New South Wales, NSW

Chronic pain is highly prevalent in multiple sclerosis (MS), a chronic, inflammatory, demyelinating, and neurodegenerative disease of the central nervous system. In this topical session, we will present a perspective of people living with MS-related pain, pharmacological and non-pharmacological management of pain in MS.

A/Prof Desmond Graham will outline the presentation of pain in people with MS, current treatment options, and the impact of pain on an individual’s quality of life.  Pain associated with Des’s MS is his major burden of the disease.  He will discuss his own pain journey, how it presents, his treatments and the impact on him and his family.

Dr Jamie Young will present three studies relating to non-pharmacological management of chronic pain in MS (case study).

Prof Maree Smith will present her work on establishing a new mouse model of MS, characterised by a discordance between motor and sensory symptoms, and findings on novel agents with the potential to alleviate MS-associated central neuropathic pain.

A/Professor Desmond Graham, MS Australia, NSW
Dr Jamie Young, University of Melbourne, VIC
Emeritus Professor Maree Smith, University of Queensland, QLD

3C: Understanding the impact of contextual factors on individual-level response to pain and its treatment
Chair: Professor Mark Hutchinson, University of Adelaide, SA

The biopsychosocial model is the widely held conceptualisation of pain. While a wealth of research supports the important role of converging biological and psychological factors in pain, the interconnected role of the social contextual frame in which they are occurring has been somewhat neglected in recent years of research. The first speaker, Professor Hutchinson will highlight the important role of pre-injury/pain contextual factors by presenting research from a biological perspective of the impact of prior life events on pain phenotype. Professor Sterling, the second speaker, will then explore the influence of a traumatic versus non-traumatic context at the point of injury, linking biological processes with the occurrence of co-morbid post-traumatic stress disorder. The third speaker, Associate Professor Day, will present data from a recently completed randomised controlled trial to elucidate the contextual role of the therapeutic learning environment and social learning processes during psychological treatment. Thus, this session will examine the role of context at pre-injury, the role of context at the point of injury, and the role of context at post-injury during treatment. The findings that will be discussed therefore have implications for the prevention of chronic pain and co-morbidities, as well as treatment optimisation.

Professor Mark Hutchinson, University of Adelaide, SA
Professor Michele Sterling, University of Queensland, QLD
A/Professor Melissa Day, University of Queensland, QLD

3D: Pain mechanism matters
Chair: Professor Lorimer Moseley, University of South Australia, SA

Pain is a personal experience that differs for every individual. There is no one-size-fits all treatment. Instead, personalised pain management is likely to be the key. How can this be achieved? Amongst the features that characterise an individual’s pain experience are an array of neurobiological processes. These processes are diverse. They not only influence the presentation of pain, but also the likely success of treatments. Unravelling the understanding and identification of mechanisms is a critical step towards personalisation of care. This session will consider three key issues regarding this challenge. First, it is critical to consider that there are different pathways to chronicity, and novel brain imaging paradigms are beginning to reveal different pain mechanism biomarkers such as modified glial cell function. Second, how psychosocial and lifestyle factors impact and relate to an individual’s pain experience depends on the underlying pain mechanism, such that two individuals challenged in a similar manner may have very difference responses. Third, for personalisation of pain management to be based on pain mechanism, it must be identifiable in clinical practice. Classification of pain into nociceptive, neuropathic and nociplastic mechanisms has been proposed, but is it possible to identify and discriminate between these in clinical practice.

Professor Luke Henderson, University of Sydney, NSW
Dr David Klyne, University of Queensland, QLD
Paul Hodges, University of Queensland, QLD

3E: Digital Health Interventions for Pain Management
Chair: Dr Ali Gholamrezaei, University of Sydney, NSW

Digital health interventions and their applications in various medical conditions are rapidly evolving. From mobile text messaging to advanced artificial intelligence, digital health is revolutionizing healthcare methods and delivery. As fast as it is evolving, consumers and clinicians are facing important questions. What types of interventions are available? Are they effective AND safe? Do consumers engage with these types of interventions? Can we effectively communicate via a digital platform as would be done in person? In this session, we will discuss interesting and important topics about digital health interventions for pain management. We will review and discuss the available evidence on different types of interventions including text messaging and online treatments for pain, including studies done in Australia. We will talk about adherence, how to measure it and how to optimize it; the scalability of digital interventions and improving access to care; how the COVID-19 pandemic has influenced the usage of available interventions; consumer involvement and user experience; how prognosis is currently communicated in digital health and how this knowledge can be applied for pain management?     

Professor Blake Dear, Macquarie University, NSW
Dr Tania Gardner, St Vincent's Hospital, NSW
Professor Paul Glare, Royal North Shore Hospital, NSW

3F: Goal setting, cognitive flexibility, and their relationship to adjustment in chronic pain
Chair: A/Professor Toby Newton-John, University of Technology Sydney, NSW

It is customary for pain management interventions, whether delivered individually or in a group format, to incorporate goal setting as a key component of the intervention package. Approaches such as the SMART goal setting protocol are commonly presented to patients to guide the process of achieving desired outcomes from their pain treatment. However, goal setting and the pursuit of treatment-related goals in chronic pain, is often much more complicated in practice.

This workshop will explore a range of clinical and theoretical issues related to goal setting, cognitive flexibility and goal pursuit for patients with chronic pain. From expert insights from experienced pain clinicians (Newton-John, Austin) to the latest research evidence from researchers in this area (Howlett, Roux), at the end of this multidisciplinary workshop the attendee will be able to.

A/Professor Toby Newton-John, University of Technology Sydney, NSW
Tim Austin, Royal Prince Alfred Medical Centre, NSW
Caitlin Howlett, Body in Mind Research Group, NSW
Lawrence Roux, Sydney Pain Management Centre, NSW