The Development Of Chronicity Following Whiplash Injury: The Fear-avoidance Model Versus A Neurobiological Stress Model.
Funder
National Health and Medical Research Council
Funding Amount
$87,476.00
Summary
Whiplash injuries following car accidents are responsible for a considerable burden on individuals and the community. This study is designed to develop our understanding as to why some people recover quickly and others have ongoing problems months after the accident. By collecting physical and psychological data shortly after their accident and 3, 6 and 12 months later, we will be able to describe the differences between people who do well and those that develop chronic symptoms.
Targeting GDNF Family Ligand (GFL) Signalling To Treat Inflammatory Bone Pain
Funder
National Health and Medical Research Council
Funding Amount
$329,285.00
Summary
Pain associated with bone marrow oedema syndromes, osteomyelitis, osteoarthritis, fractures and bone cancer causes a major burden on individuals and health care systems in Australia and worldwide. In this application, we will explore specific signalling pathways that we have identified in nerves that code bone pain. This will provide an opportunity for the rational design of highly specific drugs capable of interacting exclusively with molecules that drive pain in these conditions.
Effects Of Jaw Muscle Pain On Jaw Muscle Activity And Jaw Movement In Humans
Funder
National Health and Medical Research Council
Funding Amount
$337,770.00
Summary
Chronic facial muscle pain is a significant community health problem that is poorly understood. Current treatments are based on the idea that structural or stress-related factors result in increased jaw muscle activity which then generates pain that in turn leads to more muscle activity - the so-called Vicious Cycle Theory. Treatments therefore aim to break the cycle by focussing on reducing muscle activity and thereby alleviate the pain. There is currently, however, little scientific evidence f ....Chronic facial muscle pain is a significant community health problem that is poorly understood. Current treatments are based on the idea that structural or stress-related factors result in increased jaw muscle activity which then generates pain that in turn leads to more muscle activity - the so-called Vicious Cycle Theory. Treatments therefore aim to break the cycle by focussing on reducing muscle activity and thereby alleviate the pain. There is currently, however, little scientific evidence for this Theory. Another theory has been recently proposed in the Pain Adaptation Model. This model says that changes in muscle activity and movement are protective against further pain rather than the cause of the pain. The evidence, however, for this model is limited and conflicting. The current lack of understanding of facial muscle pain limits advancement in its management. Our long-term goal is to improve the management of patients with facial pain. The present application aims to determine whether muscle pain alters jaw muscle activity and jaw movement. Our preliminary clinical data provide compelling evidence for the Pain Adaptation Model. We are confident of a better understanding of what goes wrong in the jaw muscles in chronic facial pain and this will have implications for muscle pains elsewhere in the body. The outcome may help to refute the Vicious Cycle Theory, and help shift the focus away from signs and symptoms associated with the jaw muscles, and re-direct the focus to the alleviation of pain as the primary management goal. The information obtained should also provide a solid basis on which treatments can be tested for optimal resolution of symptoms, and an evidence-based approach in the management of facial pain.Read moreRead less
Understanding Persistent Low Back Pain Where It Resides, In The Brain
Funder
National Health and Medical Research Council
Funding Amount
$848,972.00
Summary
Low back pain is a leading cause of disability amongst Australians. A critical question is why some people get better after hurting their back while others do not. This project examines whether changes in the brain predict low back pain outcome. This information will rapidly advance our understanding of low back pain and has the potential to facilitate the development of novel therapies.
An Integrated, Multi-system Approach To Understanding Persistent Pain
Funder
National Health and Medical Research Council
Funding Amount
$419,180.00
Summary
Musculoskeletal pain is a major health problem in Australia, with an economic burden second only to cancer. Despite the scale of the problem, there are few effective treatments. This project examines a range of biological mechanisms that could explain why some people get better over time while others experiencing pain do not. The findings of this research will contribute to the development of new treatments that can be targeted to each individual to improve pain and disability.
Temporomandibular Disorders (TMD) are characterised by pain and limited jaw movement and are a significant issue. Current management is influenced by the view of a simple association between pain and limited movement. This study will test a new theory that an individual's motor response to pain is influenced by the complexity of the jaw motor system as well as the individual's pain experience. This project will point towards individualised recommendations for effective management of TMD.
Whiplash Injury: Mechanisms, Prediction And Directives For Improved Management Strategies.
Funder
National Health and Medical Research Council
Funding Amount
$772,359.00
Summary
Whiplash is a costly condition with many people developing chronic symptoms. This research aims to improve the understating of involved mechanisms, diagnosis and classification of the condition from the time of injury until either recovery or the development of persistent pain. This will facilitate the early identification of those at risk of poor recovery and will lay the foundations for the development of improved early management, particularly in primary care.
Randomised Controlled Trial Of A Tailored Podiatry Intervention To Enhance Mobility And Prevent Falls In Older People
Funder
National Health and Medical Research Council
Funding Amount
$730,975.00
Summary
Foot problems affect 1 in 3 people over the age of 65 years and are associated with reduced walking speed, difficulty performing activities of daily living, impaired balance and increased risk of falls. Although a range of health professionals provide treatment for foot disorders, the most common chronic foot problems in older people (such as corns and calluses, nail disorders and toe deformities) are frequently managed by podiatrists using treatments such as scalpel debridement of lesions, foot ....Foot problems affect 1 in 3 people over the age of 65 years and are associated with reduced walking speed, difficulty performing activities of daily living, impaired balance and increased risk of falls. Although a range of health professionals provide treatment for foot disorders, the most common chronic foot problems in older people (such as corns and calluses, nail disorders and toe deformities) are frequently managed by podiatrists using treatments such as scalpel debridement of lesions, foot orthoses, exercise prescription and footwear modifications. The 1995 National Health Survey reported that persons aged 80 years or over were most likely to have reported visiting a podiatrist in the previous two weeks, followed by those aged 65-79 years. Similarly, the Australian Department of Veterans Affairs, which provides podiatry services to veterans and their dependants, documented 606,706 episodes of podiatry care to 103,540 veterans in 1998-1999, at a cost of $23M. Podiatry therefore plays a substantial role in the maintenance of foot health and mobility in older Australians. Despite the detrimental effects of foot problems and the widespread utilisation of podiatry services by older people, very few studies have been undertaken to ascertain the efficacy of podiatry treatments. Therefore, the aim of this study is to evaluate the efficacy of an individualised podiatry intervention designed to reduce pain, enhance functional mobility and prevent falls in older people. Given the high prevalence of foot-related disability and falls in older people and their associated health care costs, the study findings will be of considerable public health importance. If found to be clinically effective, the intervention could be easily implemented into a range of healthcare settings and adopted in both state and federal falls prevention policies.Read moreRead less
An FMRI Analysis Of The Functional Organization Within The Brain Of Experimental Superficial And Deep Orofacial Pain
Funder
National Health and Medical Research Council
Funding Amount
$307,526.00
Summary
This project will investigate how the human brain processes a number of important aspects of human jaw muscle pain that are clinically relevant but poorly understood. For example, we do not understand why jaw muscle pain has such different behavioural effects to skin pain. Jaw muscle pain is associated with a significant emotional component not seen in with skin pains. Also, skin pain usually has a sharp or burning quality, is well-localized and is readily treated, while jaw muscle pain is a dee ....This project will investigate how the human brain processes a number of important aspects of human jaw muscle pain that are clinically relevant but poorly understood. For example, we do not understand why jaw muscle pain has such different behavioural effects to skin pain. Jaw muscle pain is associated with a significant emotional component not seen in with skin pains. Also, skin pain usually has a sharp or burning quality, is well-localized and is readily treated, while jaw muscle pain is a deep pain that has a dull, aching quality that may be referred to related sites of the face, head and neck. It is also not known why jaw muscle pain is more common in females in comparison to males. Chronic jaw muscle pain is a major symptom of patients with Temporomandibular Disorders, the most common form of non-dental orofacial pain and that involves pain in or about the jaw joint and-or jaw muscles, and often limitation of jaw movement. Chronic jaw muscle pain can have a severe effect on quality of life but its diagnosis and management is difficult. Despite the widespread prevalence of chronic orofacial pains, we have little information on the central processing of chronic human orofacial pain. This proposal will improve our fundamental understanding of how jaw muscle pain is processed in the brain. The way that the central nervous system processes and represents jaw muscle pain will help explain why these pains present differently in the clinic and should provide important information on the differences between females and males in the representation of jaw muscle pain. This information on the central processing of chronic orofacial pain is crucial to inform the direction of novel or specific management strategies. Our long-term goal is to improve the diagnosis and management of patients with Temporomandibular Disorders, and the present application represents a major new direction of research.Read moreRead less
Electroacupuncture On Opioid Consumption By Patients With Chronic Musculoskeletal Pain: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$368,138.00
Summary
Chronic musculoskeletal pain significantly impacts on productivity and quality of life and represents one-tenth of health expenditure. Opioids are increasingly prescribed to control this type of pain, although the long-term usage is inadequate and associated with significant adverse events. Our pilot study has shown that electroacupuncture (EA) is potentially beneficial for reducing OM. This study is to determine whether or not EA reduces OM consumption and associated adverse events.