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Pain And Trunk Muscle Control: Effects, Mechanisms And Consequences
Funder
National Health and Medical Research Council
Funding Amount
$296,452.00
Summary
Twenty-one percent of Australians report long-term back problems. This makes back pain the most common chronic pain in Australia and most prevalent disorder among the National Health Priority Areas. For the majority with recurrent and chronic problems, the cause is unknown but changes in control of the spine are thought to be important. It is well accepted that pain and injury to the low back affect the way that we control the back muscles and this leads to changes in spinal function. However, d ....Twenty-one percent of Australians report long-term back problems. This makes back pain the most common chronic pain in Australia and most prevalent disorder among the National Health Priority Areas. For the majority with recurrent and chronic problems, the cause is unknown but changes in control of the spine are thought to be important. It is well accepted that pain and injury to the low back affect the way that we control the back muscles and this leads to changes in spinal function. However, despite considerable investigation of this problem, there is a distinct lack of consensus for how the control of movement is changed during pain, why it changes, and whether these changes lead to further problems in the long term. The objective of this series of studies is to determine how the adaptation to pain changes the control of the spine. We will use a range of techniques that include tests of the strategies used by the brain to control the spine and mathematical models to estimate the effect that these changes have on the spine when people are given back pain by injecting sterile salty water into the back muscles. These studies will be backed up by measures of mechanical properties of the spine and by comparison to people with clinical pain. This combination of methods has not been used previously and is likely to help resolve the problem of how muscle control is chaged in back pain. We will also test a range of hypotheses regarding how pain has its effect on muscle activity. A final series of studies aims to determine whether the failure of these changes in muscle control to resolve after an epiosde of back pain leads to increased recurrence of pain in the long-term. The importance of this project is highlighted by the significance of back pain as a major health issue, the lack of consensus regarding the effect and mechanisms of pain on trunk muscle control (despite extensive investigation), and the potential for the findings to guide rehabilitation and management.Read moreRead less
Pain changes movement. Although undisputed, there is a surprising lack of agreement regarding the underlying mechanisms. This project involves an innovative mix of neurophysiological methods to investigate the drive to muscle cells from the nervous system and changes in the mechanics of contraction. These studies will resolve the perplexing problem of how pain changes our ability to activate muscle. Clear understanding of the underlying mechanisms can guide rehabilitation.
Testing The Imprecision Hypothesis Of Chronic Pain.
Funder
National Health and Medical Research Council
Funding Amount
$788,984.00
Summary
Pain usually occurs when something triggers activity in danger receptors, which are all over the body. The brain receives a huge amount of other sensory input too, which tells the brain what was happening when the danger arose. The brain imprints this sensory barrage and uses it as an early (painful!) warning system next time. If the imprint is imprecise, then the painful warning occurs in non-dangerous situations. We will test whether imprecise imprinting of the sensory input causes the gradual ....Pain usually occurs when something triggers activity in danger receptors, which are all over the body. The brain receives a huge amount of other sensory input too, which tells the brain what was happening when the danger arose. The brain imprints this sensory barrage and uses it as an early (painful!) warning system next time. If the imprint is imprecise, then the painful warning occurs in non-dangerous situations. We will test whether imprecise imprinting of the sensory input causes the gradual development of chronic debilitating pain.Read moreRead less
Determining The Pathomechanics Of Muscle Weakness In Older Individuals With Toe Deformities In Order To Develop Evidence-based Intervention Strategies To Restore Foot Function
Funder
National Health and Medical Research Council
Funding Amount
$316,251.00
Summary
Hallux valgus and lesser toe deformities are highly prevalent foot problems in older people that can cause foot disfigurement, physical discomfort, and increase the risk of falling. This study will investigate how toe muscle weakness is affected by these toe deformities as the basis upon which to develop interventions that can restore foot function in older individuals, in order to reduce falls risk, foot pain and, in turn, improve independence and quality of life throughout ageing.
INVESTIGATIONS ON THE REGULATION OF INTERVERTEBRAL DISC CELL MATRIX METALLOPROTEINASES
Funder
National Health and Medical Research Council
Funding Amount
$331,320.00
Summary
Degeneration of the intervertebral disc is a painful disabling condition with major socioeconomic consequences. Medical problems associated with disc degeneration and back-pain, of sufficient severity to warrant consultation with a physician, are experienced by 90% of the population some time during their lives. In man, back pain increases in incidence in the third and fourth decades of life, peaks in the fifties and declines thereafter. Changes in population demographics indicate this problem w ....Degeneration of the intervertebral disc is a painful disabling condition with major socioeconomic consequences. Medical problems associated with disc degeneration and back-pain, of sufficient severity to warrant consultation with a physician, are experienced by 90% of the population some time during their lives. In man, back pain increases in incidence in the third and fourth decades of life, peaks in the fifties and declines thereafter. Changes in population demographics indicate this problem will increase in severity over the next few decades. American Bureau of Census data indicate that between 1990 to 2010 the number of people >45 years will increase from 82 to 124 million, the number of elderly in emerging countries will also increase between 200 to 400% in the next 30 years. In the United States, back-pain is the second most common reason that people visit a physician and medical conditions related to back-pain account for more hospitalisations than any other musculoskeletal disorder. Despite its high incidence, associated problems of incapacity and economic implications, costed at $100 million per annum in Australia in 1992, and US$100 billion globally in 1999-2000 (Dorland Data Networks, PA, USA) the causes of low back-pain are still poorly understood. Disc disease is responsible for 23-40% of all cases of low back-pain. The management of discogenic low back-pain is currently empirical, directed either toward life-style changes to minimise symptomatology or to surgical resection or spinal arthrodesis to restrict articulation. Based on our recent findings and those of colleagues over the last 16 years, it is our strong conviction that it should be possible with a better understanding of disease mechanisms and with the use of modern technologies to inhibit, reverse or ideally prevent disc degeneration. Without such basic research there will be no scientific foundation upon which prospective therapies may be based.Read moreRead less
Reconsideration Of The Mechanisms Underlying Movement Changes With Pain
Funder
National Health and Medical Research Council
Funding Amount
$401,361.00
Summary
Pain changes the way we move. Although undisputed, there is a surprising lack of agreement regarding the underlying mechanisms. This project involves an innovative mix of neurophysiological methods to investigate how the drive to muscle cells from the nervous system is altered during pain. We aim to resolve the perplexing problem of how pain changes our ability to activate muscle. Our findings are likely to provide a clear understanding of the underlying mechanisms and guide rehabilitation.
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.
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