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2025 Australian Pain Society 45th Annual Scientific Meeting

2025 Australian Pain Society 45th Annual Scientific Meeting in the IASP Global Year about Pain Management, Research and Education in
Low- and Middle-income Settings
13 - 16 April 2025 | Pullman Melbourne Albert Park, VIC

Topical Sessions

Topical Sessions 1
Monday 14 April 2025, 11.00am - 12.30pm

1A: The Dark Side of Expectation: Exploring Nocebo Effects in Pain and its Management
Chair: Professor Ben Colagiuri, University Of Sydney, NSW

The nocebo effect is a fascinating and important psychobiological phenomenon whereby negative expectancies generated by the treatment context trigger worse health outcomes. Mounting evidence indicates the profound influence that nocebo effects can have in shaping pain outcomes.
This topical session will outline the latest psychological and neuroscientific research on nocebo effects in pain management. It will then explore clinical perspectives on the nocebo effect in pain management through a multidisciplinary panel discussion and audience Q&A.
Professor Ben Colagiuri will present novel research examining the psychological mechanisms of nocebo effects in pain and will highlight emerging strategies for inhibiting them. Associate Professor Natalia Egorova-Brumley will present the latest research on the neurobiological underpinnings of nocebo effects in pain. Following this, a multidisciplinary clinical panel discussion will feature Associate Professor Tasha Stanton (Physiotherapist), Professor Louise Sharpe (Clinical Psychologist), and Dr Allan Cyna (Anaesthetist/Hypnotist). The panel discussion will focus on clinical perspectives on the role of nocebo effects in pain management, including recommendations for trainees and clinicians, and priorities for future research. The panel will be interactive, allowing audience members the opportunity to ask questions. In doing so, this topical session will bridge the latest nocebo research with clinical practice and perspectives.

Speakers:
A/ Professor Natalia Egorova-Brumley, University Of Melbourne, VIC
Professor Louise Sharpe, University Of Sydney, NSW
Dr Allan Cyna, Women’s And Children’s Hospital Adelaide, SA
Professor Ben Colagiuri, University Of Sydney, NSW

1B: The IASP Global Year through an Australian Lens: Research and Action to Address Pain Inequities
Chair: Dr Emma Karran, IIMPACT in Health, University Of South Australia, SA

The International Association for the Study of Pain has designated 2025 as the Global Year about Pain Management, Research and Education in Low- and Middle-Income Settings. This session will involve the (Co-)Chairperson of the Global Year taskforce and a Gumbaynggirr woman in an exploration of this theme through an Australian lens.
• Health equity in pain research: Collecting adequate socio-demographic data, including data related to the social determinants of health, is an important step towards understanding and addressing health inequities. Emma will report the outcomes of ‘ISSHOOs in Pain Research’ - a global, multi-stage, project to reach agreement on a minimum set of equity-relevant items for inclusion in all pain research.
• Equity in academic publishing: LMICs comprise 85% of the world’s population but only a small fraction of research is published from these countries. Saurab will highlight the barriers faced by LMIC researchers and propose strategies for how the global pain community can help improve outcomes of the most vulnerable.
• Health equity in an Australian context: Jane and Sam will co-present a program of research that aims to address inequities in pain care for Aboriginal and Torres Strait Islander peoples. They will report on projects designed to improve health and wellbeing (focussing on chronic musculoskeletal conditions); and prompt attendees to consider the alignment between Western and Indigenous epistemologies in Aboriginal chronic pain research.

Speakers:
Dr Emma Karran, IIMPACT in Health, University Of South Australia, SA
Dr Saurab Sharma, Neuroscience Research Australia, NSW
Dr Jane Linton, Grafton Base Hospital, NSW
Dr Samantha Bunzli, Griffith University, QLD

1C: Storytelling makes sense, literally: A practical application for pain
Chair: Dr Jules Richards, Queensland Children's Hospital/University of Queensland, QLD

Innovation time! Together, we will explore the role of storytelling in pain management. Participants will discover the latest research on how narrative techniques can improve patient care. Dr Jules Richards, a Nurse Practitioner and teen fiction writer, will illustrate how an emotional novel excerpt can engage teens to better understand pain. Dr Joshua Pate, a Senior Lecturer in physiotherapy and primary school children’s author, will demonstrate a practical application of a series of books throughout a family’s journey of pain-related appointments. Dr Jo Rotherham, a Pain Medicine Specialist, will use her experience authoring a thriller novel to inspire the clinical use of narrative medicine. Dr Ross Watkins is a children’s author and creative writing scholar who will couch the discussions in writing theory.

Participants will then rotate through three interactive stations in table groups: (1) metaphor creation to explain pain and enhance communication, (2) crafting pain personas to gain insights into diverse pain experiences, and (3) developing narratives based on patients’ emotional journeys and pain management strategies.

The session will conclude with a 30-minute Q&A to discuss practical applications of storytelling in pain management, and inspire healthcare professionals to use storytelling as a tool to enhance patient care.

Speakers:
Dr Joshua Pate, University of Technology, NSW
Dr Joann Rotherham, Princess Alexander Hospital, QLD
Dr Ross Watkins, University of the Sunshine Coast, QLD

1D: Advancing Children's Pain Research through Innovative Methodologies
Chair: Dr Jennifer Stinson, The Hospital for Sick Children, Canada

This workshop showcases cutting-edge research methodologies in the field of pain research, highlighting innovative approaches that are advancing the field. The session features a diverse lineup of national and international presenters, bringing together interdisciplinary, cross-centre experts. Attendees will gain insights into adapting qualitative research approaches to include people with diverse communication and cognitive abilities in pain research. We share insights into iterative, user-centred design approaches to developing an AI-enhanced social robot that provides personalized support to children during needle-based procedures. We present our experiences engaging patient partners as co-hosts in qualitative interviews and reflect on how this enriched the interview process, strengthened rapport, and produced more meaningful and authentic data. The workshop will also present key findings from these recent studies, offering attendees a unique opportunity to learn about the implications of these results for clinical practice and future research.

Speakers:
Dr Nicole Pope, The University of Melbourne, VIC
Ms Meredith Smith, University Of Adelaide, SA
Dr Justine Dol, IWK Health, Canada

1E: Avoiding the Edge Before It Is Too Late: How to Detect When Pain Signals Injury in Athletes
Chair: Ms Nicole Rickerby, The University Of Queensland, QLD

Understanding when an athlete is on the edge of injury is crucial to prevent damage, optimise peak performance and enhance longevity. Although pain is a common side effect of intense exercise, it is often misinterpreted as harmless, leading athletes to “push through” potentially injury-related pain and increasing the risk of damage. The decision to continue or stop training or competing depends on a complex array of internal and external factors, from cellular changes to psychological states. The first speaker will explore how wearable sensor data can inform real-time decisions by tracking physiological responses during training, including heart rate metrics (e.g., heart rate variability), stress, and prior sleep quality. The second speaker will describe how advances in blood sample analyses can reveal cellular-level processes (e.g., immune signalling) that predict injury and provide early warning signs. The final speaker will apply a behavioural inhibition-behavioural activation (BIS-BAS) model to discuss how psychological factors influence an athlete's response to pain, highlighting how personal tendencies such as “overactive drive” can increase injury risk. This session will highlight the potential of combining methods from the molecular to cellular to whole systems alongside psychology, to radically improve pre-injury detection and pain management in athletes. Attendees will learn how they can apply this knowledge to individualise assessments, management plans and help athletes make more informed decisions to reduce injury risk and optimise performance.

Speakers:
Professor Mark Hutchinson, University of Adelaide, SA
Ms Nicole Rickerby, The University Of Queensland, QLD
Dr David Klyne, The University Of Queensland, QLD
A/ Professor Melissa Day, The University Of Queensland, QLD

1F: Early interventions following injury to improve outcomes
Chair: Professor Michael Nicholas, The University Of Sydney, NSW

In Australia, nearly 400,000 people are injured annually on roads or in the workplace. Many will struggle to return to work or normal activities, with some developing chronic pain and disability. Strategies to identify those most likely to have a poor outcome following injury have been developed and may be used by clinicians and insurers who are responsible for overseeing care of people with an injury. Currently, however, there are few options for early interventions to address risk for these individuals within existing healthcare models.. This session will explore results from several early intervention trials across clinical and insurance settings, highlighting barriers and facilitators to implementation.

Chaired by Professor Michael Nicholas, the session will begin with Alison Sim presenting the results of a pilot program on the feasibility of a co-designed, telehealth-delivered early intervention for motor vehicle injury. Professor Belinda Gabbe will discuss research on a purpose-built ward environment and a new allied health model of care for major trauma patients. Professor Michele Sterling will summarise research on the efficacy of a physiotherapist-delivered intervention addressing stress in patients with whiplash-associated disorder. A panel discussion with the audience will follow the presentations.

Target audience:
- Clinicians working with acute and chronic pain patients post-injury
- Researchers and policymakers interested in compensable injury

Speakers:
Professor Belinda Gabbe, Monash University, VIC
Ms Alison Sim, The University Of Sydney, VIC
Professor Michele Sterling, The University of Queensland, QLD

Topical Sessions 2
Monday 14 April 2025, 2.00pm - 3.30pm

2A: Phenotyping pain characteristics: Back translation for patient heterogeneity
Chair: Dr James Kang, University Of Sydney, NSW

The use of laboratory animals in pain research is essential if new and clinically relevant knowledge about the mechanisms of pain is to be acquired. Studies using animals to model chronic pain conditions require the highest ethical and experimental standards. The choice of animal and procedures must balance the ethical considerations with the principal objective of alleviating or preventing pain, as well as improving the quality of life. The face validity of animal models of experimental pain requires the appreciation of the (i) complex behavioural and physiological disruptions, (ii) altered sensation, and (iii) patient heterogeneity (individual differences) that are observed in the clinical setting.

In this topical session we will discuss:
1. How should we measure pain?
2. When should we start measuring pain?
3. What is clinically relevant ‘pain’ relief, and can we simulate this?
4. A mouse is not a rat, and a rat is not a human.

Speakers:
Professor Andrew Rice, Imperial College London, United Kingdom
Dr David Klyne, The University Of Queensland, QLD
Dr Luke Grundy, Flinders University, SA
Ms Olivia Davanzo, University Of Sydney, NSW
Ms Dhanya Shanmuganathan, Monash University, VIC

2B: Rural Realities vs Urban Ideals: Breaking the Metro Mould of Pain Management in Rural Australia
Chair: Ms Sophie Shephard, Vive Pain and Fatigue, NSW

It is well recognised that it is challenging to provide effective pain management in regional, rural, and remote areas. Rural Australians experience both disproportionate pain burden and inequitable access to pain services. This session brings together researchers and clinicians with diverse perspectives and lived experiences of rurality, to critically cross-examine the issues surrounding implementation of ‘evidence informed’ pain management in rural Australia from multiple lenses and system levels.

First, we will present a critique of existing pain management research and policy through a rural lens, to unearth and challenge unconscious urbanormative assumptions and biases influencing current practice. We will then examine translation of current pain research and policy, illuminated by insights into rural-specific factors affecting the provision of guideline-based pain care and the success of initiatives seeking to support pain care in rural areas. We then provide practical accounts of current and innovative models of pain care in several rural Australian settings.

This session is suitable for anyone involved in pain management research, policy, or care delivery - not just those working in rural health. We intend to challenge and inspire – to help us ‘re-think’ the problem of rural pain management, identify systemic barriers and norms that continue to produce rural health inequities, inform inclusive and equitable research practices, and highlight the need for fit-for-purpose approaches to rural pain management.

Speakers:
Ms Sophie Shephard, Vive Pain and Fatigue, NSW
Mrs Ashley R Grant, University of South Australia, IIMPACT in Health, SA
Dr Ian Skinner, Charles Sturt University, NSW
Dr Ruth Hardman, Sunraysia Community Health Services, VIC

2C: The Journey is More Important than the Destination: Engaging an Integrative Approach to Explore the Relationship Between Early Life Trauma and Chronic Pain
Chair: Professor Richelle Mychasiuk, Monash University, VIC

Chronic pain is a complex, subjective, and multifactorial experience that unfolds within social contexts. Recent research has demonstrated that adverse childhood experiences (ACEs) significantly modify physiological and mental health in adulthood. While the etiology of chronic pain is often unknown, emerging research provides compelling evidence that its manifestation often begins early in life and is linked to ACEs.
We are an international, (Canada, Australia), interdisciplinary panel consisting of a lived experience consumer and documentarian (Murphy), clinical psychologist (Noel), and developmental neuroscientist (Mychasiuk). Through this unique collaboration, we will not only present new, unpublished clinical and preclinical data, but will concurrently incorporate this data with lived-experience storytelling. This session will diverge from typical symposium formats by simultaneously highlighting innovative research with key excerpts from Murphy’s documentary “Stuck” – which was produced to chronical his journey towards understanding how ACEs contributed to his lifelong struggle with chronic pain.
This topic is not without controversy. There is debate about what constitutes trauma and how we can produce impactful interventions and even prevent chronic pain before it arises. The retrospective nature of ACE reporting in adulthood, and the risk of re-traumatization, are also issues that can lead to contention. We embrace debate and dialogue and will incorporate substantial time for lively and stimulating discussions within our session.

Speakers:
Professor Richelle Mychasiuk, Monash University, VIC
Mr Robert Murphy, Monash University, VIC
A/Professor Melanie Noel, University of Calgary, Canada

2D: Gabapentinoids for chronic pain – game changer or looming crisis?
Chair: Ms Amy McNeilage, The University Of Sydney, NSW

Australia has one of the highest rates of gabapentinoid use globally. Indeed, around one in three patients presenting to Australian pain services is prescribed gabapentin or pregabalin. Though only approved for neuropathic pain, gabapentinoids are widely used off-label for other chronic pain conditions despite limited evidence supporting their use. Concerns about potential harms, such as dependence and overdose, are growing. At the same time, however, patients and clinicians report gabapentinoids offer a safer alternative to opioids. In this dynamic, multidisciplinary session, researchers and clinicians will delve into the contentious use of gabapentinoids for chronic pain, examining both their potential benefits and hidden risks.

Amy McNeilage will begin the session with insights from her qualitative studies on patient experiences of using gabapentinoids. Professor Suzanne Nielsen will present findings on pregabalin’s effectiveness in a chronic pain cohort prescribed opioids, and substitution prescribing following prescription drug monitoring implementation in Victoria. A/Professor Bridin Murnion will discuss emerging evidence for harms and the known risk factors for misuse and dependence. Finally, A/Professor Michael Vagg will offer “real world” insights into gabapentinoid prescribing and deprescribing in patients with chronic pain. Four brief presentations will be followed by an in-depth and interactive panel discussion.

Speakers:
Ms Amy McNeilage, The University Of Sydney, NSW
Professor Suzanne Nielsen, Monash University, VIC
A/ Professor Bridin Murnion, The University of NSW, NSW
A/ Professor Michael Vagg, Pain Matrix, VIC

2E: Horses for courses: is surgery necessary for some people with back pain?
Chair: Mr Steven Marsh, UNSW Sydney, NSW

Recent international guidelines for the management of chronic low back pain exclude recommendations on surgical management or suggest it has ‘at best’ a limited role for patients with chronic low back pain. However, for people with continuing severe pain and significant impacts on their daily life, where concomitant spinal disorders are identified, surgical treatments are offered. Indeed, rates of privately funded spinal surgeries are increasing rapidly in Australia.

In a world of pain that is biopsychosocial in nature, is surgery the right treatment for some people with spinal disorders? How do we know if surgery works? Can we identify people who do better with certain surgeries? Who do surgeons think these people are, and what do people who’ve undergone these procedures think? This workshop will take attendees on a journey through a combination of quantitative and qualitative research on the provocative topic of the surgical management of spinal disorders.

This topical session aims to ignite discussion amongst attendees of all backgrounds with presentations on the use of surgical placebos, observational data to make causal claims, qualitative insights into surgeons’ decision-making, and insights from a surgeon does these operations and a consumer who has received them.

Speakers:
Professor Manuela Ferreira, The George Institute for Global Health, NSW
Dr Jonathan Quicke, The University Of Queensland, QLD
Dr Paul Licina, Brisbane Private Hospital, QLD
Mr Harrison Hansford, Neuroscience Research Australia, NSW

2F: Is less more? Optimising duration and content of group pain management programs
Chair: A/ Professor Carolyn Arnold, Alfred Health, VIC

This session will explore the real word practicalities of group pain management programs. It will delve into what works well in these programs, what doesn’t, and how to integrate an interdisciplinary approach effectively. Aimed at clinicians, including medical specialists, nurses, and allied health professionals, the session will demonstrate how patient-reported outcome measures (PROMs) can inform the optimisation of both the duration and content of these programs.

Topics will cover practical experiences and evidence-based strategies for determining the ideal program length and key content areas that maximise patient outcomes. We will explore innovative approaches to program delivery, including maximising patient engagement and retention across diverse populations. The session will share first-hand insights from delivering group management programs and contrast these experiences with the published literature, analysing the gap between controlled trials and the real-world experience.

The session will conclude with an interactive panel discussion that will encourage participants to reflect on their own practice and experiences. This panel will cover a broad range of topics, such as the suitability of all patients for group management, effectiveness versus cost-effectiveness, and the challenge of creating group programs that incorporate multidisciplinary approaches while also addressing the unique needs of individual patients.

Speakers:
A/ Professor Jon Ford, Advanced Health Care, VIC
Dr Paul Cadzow, Sunshine Coast Persistent Pain Management Service, QLD
Dr Brigitte Phillips, electronic Persistent Pain Outcomes Collaboration, NSW
Mr Jay Whittem, Sunshine Coast Persistent Pain Management Service, QLD
Professor Michael Nicholas, University of Sydney, NSW

Topical Sessions 3
Tuesday 15 April 2025, 10.45am - 12.15pm

3A: Post-amputation pain: 100 years of progress
Chair: Mr Jackson Linke, UNSW Sydney, NSW

Post-amputation pain is a burdensome condition characterised by either pain in the residual limb or pain perceived in the missing limb after an amputation, or phantom limb pain. Approximately 80% of people who have undergone an amputation experience post-amputation pain during their life. Symptoms vary with some patients reporting shooting, electric-shock type pain and others, a crushing, vice-like grip being felt in the missing limb. The consequences of post-amputation pain can be profound, often leading to psychological distress, sleep disturbance, and reduced quality of life.

This topical session will use a historical perspective to gain insights into contemporary evidence-based management strategies and outcome measurement. The speakers will explore the impact and natural history of post-amputation pain by examining the long-term outcomes of amputations that occurred during the First World War. Recent advances in surgical, pharmacological, and rehabilitation treatments for post-amputation pain will be presented and evaluated. Finally, outcome measurement for this population will be described and evaluated.

The aim of this workshop is to provide a platform for discussion about the history of post-amputation pain, the current evidence for its management, and methods for measuring outcomes for people with post-amputation pain.

Speakers:
Professor Andrew Rice, Imperial College, United Kingdom
Dr Heather Batten, University Of Queensland, QLD
Professor James McAuley, Neuroscience Research Australia, NSW
Mr Jackson Linke, UNSW Sydney, NSW

3B: Propa pain services by and for Aboriginal and Torres Strait Islanders, for access that is sooner, closer, cheaper and culturally safe
Chair: A/Professor Paul Gray, Tess Cramond Pain and Research Centre, QLD

Aboriginal and Torres Strait Islander peoples’ access and outcomes from pain services will improve if they are designed by and for community, with their cultural needs at the forefront. Two Persistent Pain Services have partnered with their respective ACCHO’s, IUIH and NCAACH, in the attempt to put this principle into practice through collaboration and novel service design. Creating identified roles, commissioning local artwork to represent the service and building novel education resources and programs are examples of this. This topical session will engage the audience in yarning about questions and answers to enable improved pain management. Presenters will share consumer, clinician, management and research perspectives, for comprehensive understanding of:

Why collaborative services are needed: Aboriginal presenters will share lived experience, case studies and evidence of the embedded systemic barriers to access that exist for Aboriginal and Torres Strait Islander people.

How collaborative services can be developed: We describe how the Queensland Health’s Connected Community Pathways funding was achieved, and the Propa collaborative service design that was undertaken.

What the outcomes and learning have been achieved: Mixed methods of service evaluation will be presented, with quantitative service outcomes and qualitative understanding from yarns with clinicians, clients and observation of the service.

Speakers:
Ms Morgan Brodhurst-Hill, Institute for Urban Indigenous Health, QLD
Ms Stacey Leigh, Sunshine Coast Persistent Pain Management Service, QLD
Mr Jay Whittem, Sunshine Coast Persistent Pain Management Service, QLD
Ms Kaydi Enoch, Institute for Urban Indigenous Health, QLD
Ms Christee Dos Remedios, North Coast Aboriginal Corporation For Community Health, QLD
Ms Caroline Zanussi, Persistent Pain Networking Drinks, QLD

3C: Experimental promise and pitfalls: Lessons and opportunities for using virtual reality in clinical pain research
Chair: Dr Tasha Stanton, University of South Australia, SA

This session will consider the use of virtual reality (VR) in pain research – exploring what works and just as importantly, what doesn’t work. Attendees will gain insights into contemporary virtual reality paradigms from researchers who are on the forefront of using this technology to push the boundaries of what is possible in pain research.

First, Dr Flavia Di Pietro will discuss the validation of a novel VR threat paradigm involving virtual clinical consultation rooms for use in experimental pain research, generating hypotheses for clinical encounter contributors to pain. She will also discuss the challenges of measuring physiological parameters while using VR. Second, Ms Erin MacIntyre will explore the use of VR for assessment of environmental threat in clinical populations with fear of movement, as well as presenting new findings showing that VR cycling can enhance exercise engagement in people with painful arthritis. Finally, Dr Ebonie Rio will present findings from a novel VR study exploring how manipulating visual information may be used to reduce pain during movement for people with knee pain. The presenters will discuss how VR can be harnessed to address key methodological challenges in pain research and provide examples on how this technology can be integrated into research and clinical settings. The session will end with hands-on demonstrations of VR programs, allowing attendees to experience the technology first-hand.

Speakers:
Dr Ebonie Rio, La Trobe University, VIC
Dr Flavia Di Pietro, Curtin University WA
Ms Erin MacIntyre, University Of South Australia, SA
Dr Tasha Stanton, University of South Australia, SA

3D: Targeting misconceptions and inequities in the public messaging of pain
Chair: Dr Sarah Wallwork, University Of South Australia, SA

Public misconceptions about pain and pain management are widespread. These misconceptions are likely generated from early childhood and reinforced throughout adolescence and into adulthood, through multiple sociocultural contexts. In this topical session, we will present a developmental lens on the socialisation of pain through public messaging across a multitude of systems and formats. We will discuss how this messaging contributes to inequities and biases in pain treatment and how it can be dismantled and transformed.

Adrian Traeger will talk about his research in public health messaging from recent clinical trials. He will discuss the challenges associated with public messaging initiatives, particularly when these messages are counter to broader societal beliefs/behaviours. Sarah Wallwork will then talk about her research into the origins of societal misconceptions about pain and health management. She will present evidence from the early years of life, to argue why, what, and how we could address public messaging from early childhood. Melanie Noel will then talk about her research dissecting the sociocultural representation of pain in popular media throughout critical periods of development. She will draw from new participatory research with youth to discuss how media narratives can be reclaimed and transformed to shift the culture of pain.

Speakers:
Dr Sarah Wallwork, University Of South Australia, SA
Dr Adrian Traeger, University Of Sydney, NSW
A/Professor Melanie Noel, University of Calgary, Canada

3E: Enabling precision management for chronic migraine by identifying brain biomarkers and clinical profiles (bio-signatures) of responders to treatments
Chair: Professor Trudy Rebbeck, University Of Sydney, NSW

Professor Trudy Rebbeck (Chair) will open the session outlining the problem of chronic migraine (costing $35b annually) largely due to the current global crisis of inability to predict treatment response. The consumer voice and call to find a solution will be highlighted.
Dr Aimie Peek (neuroscientist and physiotherapist) will discuss her research which outlines the potential role of brain neuro-chemicals (GABA and glutamate) in people with migraine. She’ll discuss how these brain neuro-chemicals (detected with advanced neuro-imaging) may be a potential bio-signature for treatment response.
Dr Caroline Airey (neurologist) will discuss the evidence and role of pharmacological treatment for people with chronic migraine including Botox and CRGPmAbs. He’ll describe how neurologists may currently select treatments.
Dr Zhiqi Lang (physiotherapist) will then discuss the role of non-pharmacological treatment in migraine. She will highlight her work in neck pain and migraine that informed clinical profiling of people who may have a neck (musculoskeletal) component) to their migraine picture.
The session will conclude with a panel discussion (facilitated by Prof Rebbeck) around a real case that highlights how this work may enable precision management in the future, such that clinicians can determine the right treatment at initial point of care.

Speakers:
Dr Aimie Peek, University of Sydney, NSW
Dr Caroline Airey, Brisbane Neurology, QLD
Dr Zhiqi Lang, University Of Queensland, QLD

3F: Person-centred care – what does it really look like?

Chair: Dr Samantha Bunzli, Griffith University and Royal Brisbane And Women's Hospital, QLD

Person-centred care is considered the cornerstone of high value care, for people living with musculoskeletal pain conditions. Clinical guidelines advocate clinicians provide person-centred care. Yet there appears to be a guideline – practice gap, where people living with chronic pain continue to report feeling unheard, stigmatised, and invalidated during interactions with health care practitioners. People living with pain describe a desire to work in partnership with health care practitioners where their goals, values and preferences for their care are considered. Sadly this often doesn’t happen in clinical consultations.

This focussed symposium draws together leaders in person-centred care, to focus on what person-centred care really looks like in clinical practice. It will provide real world practical examples that can be applied into practice. This will include:
- how to reassure and validate people in consultations creatively, through the lens of Acceptance and Commitment Therapy.
- how to incorporate ‘clinical yarning’ into person centred care when working with Aboriginal and/or Torres Strait Islander people.
- how behavioural learning can be used as a pathway to support people with disabling low back pain reach their goals.
The symposium will be interactive and practical.

Speakers:
Professor Tamar Pincus, The University of Southampton, United Kingdom
A/ Professor Ivan Lin, WA Centre For Rural Health, UWA, WA
Dr Samantha Bunzli, Griffith University and Royal Brisbane And Women's Hospital, QLD
Miss Brooke Conley, University Of Melbourne, VIC
Professor Peter O'Sullivan, Curtin University, WA

Topical Sessions 4
Wednesday 16 April 2025, 1.30pm - 3.00pm

4A: Bridging the gaps in research between animal and human pain research
Chair: Professor Paul Hodges, The University Of Queensland, QLD

Back-and-forth translation between animal and human pain research is compromised by many issues. This has compromised translation of treatments from animal models to humans, and gaps in understanding the mechanisms for nociception and pain. For instance, although animals express pain-like (nocifensive) behaviours when exposed to noxious stimuli and experimental models that replicate human pain conditions (e.g., animal models of colitis; nerve injury; tissue injury), it is unclear that this can interpret this as pain. Further, conceptualisation of pain types/phenotypes in humans (neuropathic, nociceptive and neuropathic) are used differently or not at all in the animal literature which hampers communication. Major barriers are different definitions for key phenomena used in animal and human literature (e.g., allodynia, hyperalgesia) and there is lack of clarity of the relationship between measures applied in animals and those applied in humans – which measures in humans relate to which measure in animals? This topical session will bring together experts in pain research in humans and animals from different disciplines to present the challenges and propose solutions. A framework and suite of measures will be presented that could overcome this translation challenge to facilitate future research seeking to understand nociception and pain, and its treatment.

Speakers:
Professor Brian Key, The University Of Queensland, QLD
Professor Stuart Brierley, South Australian Health And Medical Research Institute (SAHMRI), SA
Dr Brooke Coombes, University Of Queensland, QLD
Professor Paul Hodges, The University Of Queensland, QLD

4B: Advocating for evidence-based treatments in low back pain – why, what and how
Chair: Professor Christine Lin, The University Of Sydney, NSW

This session will feature presenters from the clinical, research and consumer communities, and stimulate a discussion on the WHY, WHAT and HOW of advocating for evidence-based treatments to be provided in low back pain.

Low back pain is one of the leading causes of disease burden globally. Discoveries from recent research have led to changes in back pain guidelines, moving away from a focus on pharmacotherapy to non-pharmacological, non-surgical treatment recommendations. However, translating evidence to change practice is a challenge, e.g. out-of-pocket costs and limited availability present barriers to accessing non-pharmacological or multidisciplinary services.

This session will start with 4 talks:
WHY – Dr Jessica Pisaniello will present her work on the projected burden and costs of back pain in Australia to the year 2045.
WHAT – Prof James McAuley will provide an update on the evidence of treatments for low back pain.
HOW – Dr Nathalia Costa will present her work on the drivers of practice variation from the perspectives of policy makers, clinicians and consumers.
HOW – Louise Hardy will present the work of the peak consumer body, Arthritis Australia, in advocating for better care in musculoskeletal conditions.

This will be followed by an interactive session with the audience to extend the discussion on what can be done to advocate for evidence-based treatments in low back pain, and how we can do so.

Speakers:
Dr Jessica Pisaniello, Monash University, VIC
Professor James McAuley, Neuroscience Research Australia, NSW
Dr Nathalia Costa, The University Of Queensland, QLD
Ms Louise Hardy, The University Of Sydney, NSW

4C: Why the quality of healthcare provider treatment delivery matters
Chair: Ms Leone Bennett, ACT Pain Centre, VIC

The quality of treatment delivery may be a critical, yet understudied mechanism that likely accounts for the heterogeneity of treatment outcomes in chronic pain. An important component of quality of care is the therapeutic alliance between the provider and patient. The first speaker will present data from randomised controlled trials (RCTs) evaluating the role of such relational qualities and how alliance can be a vehicle for improved outcomes. The second speaker will transition the discussion towards behaviours of psychologists that build that alliance, using RCT data to identify critical elements distinguishing not just ‘competent’ psychologists, but psychologists who deliver optimal quality treatment. The third speaker will present data from evaluations of physiotherapist delivered psychologically informed care to identify what qualities matter in this context. Finally, the last speaker will present findings from a large qualitative study with 200 consumers who completed the National Pain Survey led by Chronic Pain Australia which identified what qualities/skills consumers most value in GPs/primary care providers. The session will include interactive polls and an interactive workshop to engage audience members to discuss what makes a quality care provider, does it differ across specialties, and how to train healthcare providers to deliver quality, optimal care.

Speakers:
A/ Professor Melissa Day, The University Of Queensland, QLD
Professor Dawn Ehde, The University Of Washington, USA
Professor Michele Sterling, The University Of Queensland, QLD
Ms Ingrid Bindicsova, The University Of Queensland, QLD

4D: Non-pharmacological interventions to enhance acute pain management in the Emergency Department
Chair: Professor Zhen Zheng, RMIT University, VIC

One in two people who present to emergency departments (ED) in Australia suffers from pain. Effective acute pain management significantly impacts patient recovery and overall hospital experience. Current management strategies primarily rely on pharmacological interventions, which are not effective for all patients. Notably, over 90% of ED patients express a willingness to try non-pharmacological interventions for acute pain management. However, the use of these interventions remains uncommon in ED settings, and both the evidence supporting them and their implementation are not widely disseminated among healthcare professionals.

In this session, a diverse group of practitioners and researchers, including an ED physician, a nurse practitioner, an advanced physiotherapy practitioner, and acupuncture researchers and practitioners, will present various evidence-based non-pharmacological interventions that have been used in the ED for acute pain management. Data from the literature, as well as from the presenters' own research, will be shared. The session will also explore challenges and facilitators in implementing these interventions, drawing on real-life examples. This session is suitable for healthcare professionals working in ED and acute pain services in hospital settings.

Speakers:
Professor Zhen Zheng, RMIT University, VIC
Dr Michelle Mok, Northern Health, VIC
Professor Tony Zhang, RMIT University, VIC
Ms Letty Bastian, Northern Health, VIC
Mr Tom Collins, Northern Hospital, VIC

4E: Eat, sleep, play: The role of interoception in building self-management skills for chronic pain
Chair: Dr Katherine Brain, University Of Newcastle & Hunter Integrated Pain Service, NSW

Interoception is the sensory system that indicates fluctuations in homeostatic function such as hunger and thirst; sleep, fatigue and wakefulness, as well as the mind body sensations when we connect, move and explore. Interoceptive dysfunction directly affects the experience of pain and people’s behavioural choices.

In this session, Jessica Spencer (OT) will introduce the relationship between body signals and chronic pain; and how it fits into the multidisciplinary approach to pain self-management. The team will then demonstrate the broad applications of interoception in pain self-management with Dr Katherine Brain (dietitian) discussing hunger, thirst, interoception and pain. She will explore the implications this has on nutrition and pain management. Emily Peelgrane (OT) will further the discussion by identifying the links between interoception and sleep quality as well as how this might link to pain. She will also explore the links between interoception and sleep initiation. Fiona Thomas (OT) will explore how interceptive skills impact play and work performance and how activity can, in turn, be used to build interoceptive awareness and accuracy. In the second half of the session, Jessica and the team will facilitate a fun and engaging practical activity. You can then take the skills you learn and apply them directly in your practice.

Target audience: Healthcare professionals working in a multidisciplinary team to provide active pain management.

Speakers:
Dr Katherine Brain, University Of Newcastle & Hunter Integrated Pain Service, NSW
Ms Jessica Spencer, Bloom Healthcare, WA
Ms Emily Peelgrane, The Rehabilitation Specialists, ACT
Ms Fiona Thomas, Caulfield Pain Management And Research Centre, VIC

4F: Paediatric and Adult Patient Attrition and Engagement with Chronic Pain Services
Chair: A/ Professor Greta Palmer, Royal Children's /Royal Melbourne Hospitals, VIC

Attrition from chronic pain clinics limits patients from receiving maximum benefit from evidence-based interventions, with likely persistence of chronic pain and functional impairment.

Attrition data from the Paediatric electronic Persistent Pain Outcomes Collaboration (PaedePPOC) will be presented where nearly one in five children (19.3%) began but did not complete an interdisciplinary outpatient pain clinic intervention. Those who ended treatment early had longer pain duration, were older, and had caregivers experiencing higher psychosocial burden at the start of treatment compared to treatment completers. Pre-treatment screening may help tailor support, potentially reducing attrition and conserving finite clinical resources.

Patient engagement is relevant to attrition. Engagement is a dynamic process in which patients actively partner with the healthcare team as essential contributors, bringing critical knowledge regarding their own care needs. The partnership ideally empowers patients to participate in shared decision-making. Theory and evidence from various fields relevant to patient engagement will be presented.

The session will conclude with a discussion on strategies to improve patient engagement and retention, demonstrating a folder within an electronic medical record for documenting persistent pain (type, investigations, outcomes, interventions) and an associated "Healthy Planet" platform, used at an adult chronic pain clinic, to foster the patient-clinician partnership.

Speakers:
A/ Professor Greta Palmer, Royal Children's / Royal Melbourne Hospitals, VIC
Miss Kristen Tiong, Sydney Children’s Hospital, NSW
A/ Professor Tiina Janiste, Sydney Children’s Hospital, NSW
Ms Felicity West, Royal Melbourne Hospital, VIC