Back pain

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Almost everyone experiences back pain at least once in lifetime. A quarter of Australians report low back pain at any one time. It is the leading cause of disability worldwide and results in substantial personal and societal costs. Low back pain costs the Australian health system over 9 billion dollars each year. Over 90% of all low back pain problems cannot be attributed to a serious cause (such as fracture, cancer, infection) and are termed as non-specific low back pain. Low back pain can be classified as acute (less than three months in duration) and chronic (low back pain lasting three months or longer).

Most people with non-specific back pain recover within six weeks. Staying active, getting informed and avoiding bed rest usually speeds up recovery. However, many people continue to experience chronic low back pain for months or even years and some are unable to continue their work. It is now widely accepted that changes in the nervous system including the brain, play an important role in pain persisting long after tissues have healed.

In general, non-drug interventions such as exercise, cognitive behavior therapy and mindfulness are recommended for the management of chronic low back pain rather than drug and surgical approaches. However, non-drug interventions for chronic low back pain still offer limited effects to reduce pain and disability.

About our research

The Centre for Pain IMPACT aims to understand why some people with low back pain do not recover and develop chronic low back pain. We are also developing and testing new interventions to prevent and treat chronic low back pain. See below links to our past and current projects in low back pain.

Research from our Centre has been included and cited in several international clinical practice guidelines.

Participate in our future research

To participate in back pain research in the future, please leave your details below:

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Community presentations

Prof James McAuley, Senior Research Scientist and Director of the Centre for Pain IMPACT at NeuRA, has a strong philosophy of taking knowledge obtained by research beyond the confines of academia and into the community. To achieve this, James and his research team have been giving presentations to community groups on their latest research and scientific findings. These free, one-hour presentations are popular and well received. If you are interested in booking Prof McAuley and his team for a presentation or for further information, please contact our team: pain@neura.edu.au.

https://www.neura.edu.au/staff/dr-james-mcauley/

OUR LATEST RESEARCH

Social Media for Low Back Pain


DR ADRIAN TRAEGER, EDEL O’HAGAN, PROFESSOR JAMES MCAULEY

Social media is a potentially powerful tool to provide a message of education and reassurance to the general public about low back pain. This project will use social media to educate the general public about low back pain and promote self-management.

The project involves three stages. Firstly, we will conduct a content analysis to gain an insight into social media users’ perceptions and understanding about low back pain. This could determine whether social media could serve as an educational tool through which accurate information related to low back pain could be disseminated to the public.

Second, a recent Delphi survey of 150 low back pain researchers identified 30 key messages considered to be important for the general public to know about LBP. These statements provide evidence-based information on the diagnosis, prognosis and management of LBP and are intended to educate, reassure and promote self-management. We will investigate the attitude of the general public towards these messages.

Third, working in conjunction with a media company Y&R, we will design and test a social media campaign to encourage self-management for people with low back pain.

RESOLVE Trial for Chronic Low Back Pain


PROFESSOR JAMES MCAULEY, DR MATTHEW K BAGG, DR AIDAN CASHIN, DR MARKUS HüBSCHER, DR HOPIN LEE, RODRIGO RIZZO, ASSOCIATE PROFESSOR SYLVIA GUSTIN, PROFESSOR LORIMER MOSELEY, DR MARKUS HUEBSCHER, EDEL O’HAGAN, HAYLEY LEAKE, ANIKA HAIGH

For people with long term back pain that is not getting better. We are testing two pain treatment programs that target the brain, for people with chronic low back pain.

DISCOVER: Discovery of a cortical biomarker signature for pain


DR SIOBHAN SCHABRUN

Low back pain (LBP) is ranked as the top single cause of disability worldwide. Costs have risen faster than for any other health condition and LBP is now equal to ischemic heart disease, and second only to cancer, as the costliest health condition. Approximately 40% of people who experience acute LBP develop chronic pain. These individuals are unresponsive to treatment, experience high levels of pain, struggle to perform daily tasks and frequently develop psychosocial comorbidities. The enormous scale of the problem is matched only by the mystery that accompanies it: despite decades of research, why some people develop chronic LBP while others do not, remains unknown.

The identification of biomarkers that can predict who will develop chronic LBP is a holy grail of pain research. Our new research has uncovered evidence for a unique biomarker signature that appears to predict i) an individual’s susceptibility to high pain severity, even before pain begins and ii) an individual’s susceptibility to developing chronic LBP following an acute episode. These biomarkers are now undergoing detailed investigation in on-going studies.

Medicines for Back Pain


DR MARKUS HüBSCHER, PROFESSOR JAMES MCAULEY, DR MATTHEW K BAGG, MICHAEL WEWEGE, MICHAEL FERRARO, RODRIGO RIZZO, HAYLEY LEAKE, PAULINE ZAHARA, EDEL O’HAGAN, DR AIDAN CASHIN, THIAGO FOLLY, ASSOCIATE PROFESSOR SYLVIA GUSTIN, DR MATTHEW JONES, DR MARKUS HUEBSCHER

Medicines are the most common treatment for back pain. The aim of this program of research is to improve our understanding of the clinical effects of medicines.

Studies currently in progress:

  1. Scoping review of paracetamol, NSAIDs and opioid analgesics for chronic low back pain (led by Matthew K Bagg). The objective of this study is to identify and describe the characteristics of available clinical trials of commonly used analgesic medicines for chronic low back pain. This information will inform the design and conduct of other studies in the research program.
  2. Paracetamol, NSAIDs and opioid analgesics for chronic low back pain: a network meta-analysis (led by Matthew K Bagg). The objective of this study is to produce information about the clinical effects of available analgesic medicines for chronic low back pain. This information will be available in a Cochrane review to assist clinical prescription of medicines. The protocol is published and available here.
  3. Prescribing practices of medicines for adults with low back pain: a systematic review (led by Michael Wewege). The objective of this study is to determine how different medicines are prescribed to adults with low back pain and how this differs across countries. The protocol for this study is being developed.
  4. Analgesic medicines for adults with low back pain: a network meta-analysis (led by Michael Wewege). The objective of this study is to evaluate the comparative effectiveness of a range of analgesic medicines for adults across different classifications of low back pain. The protocol for this study has been submitted for publication.
  5. Muscle relaxant medicines for low back pain: a systematic review and meta-analysis (led by Aidan Cashin and Thiago Folly). The objective of this study is to determine the effectiveness and tolerability of muscle relaxant medicines for adults with low back pain. The protocol is available here.
  6. Novel biologic medicines for low back pain: a systematic review and meta-analysis (led by Rodrigo Rizzo). The objective of this study is to determine the effectiveness and tolerability of novel biologic medicines for adults with low back pain. The protocol is available here.

Completed studies:

  1. Evaluation of the impact of unpublished data from clinical trial registries on the effects of medicines for low back pain (led by Matthew Bagg). The objective of this study was to evaluate whether there is a difference between clinical trial data that are published and those that are not published. The findings are published in the Journal of Clinical Epidemiology.
  2. Antidepressant medicines for low back pain: a systematic review and meta-analysis (led by Michael Ferraro). The objective of this study was to determine the effectiveness and tolerability of antidepressant medicines for adults with low back pain. The findings have been submitted for publication. The protocol is available here.

Medicines for Back Pain – Publications:

  • Bagg MK, McLachlan AJ, Maher CG, Kamper SJ, Williams CM, Henschke N, Wand BM, Moseley GL, Hübscher M, O’Connell NE, van Tulder MW, Nikolakopoulou A, McAuley JH. (2018). Paracetamol, NSAIDS and opioid analgesics for chronic low back pain: a network meta-analysis [Protocol]. Cochrane Database of Systematic Reviews, Issue 6. doi: 10.1002/14651858.CD013045. PMCID: PMC6513465
  • Bagg MK, O’Hagan E, Zahara P, Wand BM, Hübscher M, Moseley GL, McAuley JH. (2020). Reviews may overestimate the effectiveness of medicines for back pain: systematic review and meta-analysis. Journal of Clinical Epidemiology. doi: 10.1016/ j.jclinepi.2019.12.006. PMID: 31816418

Medicines for Back Pain – Registrations of Study Protocols:

  • Folly T, Bagg MK, Wewege M, Ferraro MC, Schabrun S, Gustin SM, Day R, McAuley JH. (2019) UMbRELLA: Understanding efficacy and safety of Muscle RELaxant medicines for Low back pain – systematic Literature review and meta-Analysis (protocol).Open Science Framework, available at: https://osf.io/xuw5h
  • Rizzo RN, Bagg MK, Ferraro MC, Wewege M, Cashin A, Leake HB, O’Hagan E, Jones M, McAuley JH. (2020). Efficacy and safety of medicines targeting neurotrophic factors in the management of low back pain: protocol for a systematic review and meta-analysis. Open Science Framework, available at: https://osf.io/zax6d
  • Ferraro MC, Bagg MK, McAuley JH. (2019). RADICAL: Systematic Review of Anti-Depressant Medicines if Considered Analgesics for Low Back Pain (protocol). Open Science Framework, available at: https://osf.io/cedm3

SLEEPain


DR MARKUS HüBSCHER, PROFESSOR JAMES MCAULEY, ASSOCIATE PROFESSOR SYLVIA GUSTIN, EDEL O’HAGAN

For people with back pain who are having trouble with their sleep. We are testing whether a simple sleep tablet will help people reduce their pain and sleep better.

Patient Education to PREVENT Chronic Low Back Pain


DR MARKUS HüBSCHER, DR ADRIAN TRAEGER, DR HOPIN LEE, PROFESSOR JAMES MCAULEY, ASSOCIATE PROFESSOR SYLVIA GUSTIN, PROFESSOR LORIMER MOSELEY

For people with a new low back pain episode. We are testing early intervention to reduce the risk of developing chronic low back pain.

TEAM LEADERS IN BACK PAIN

DR SIOBHAN SCHABRUN Senior Research Scientist and Group Leader, NeuRA Director, Centre for Pain IMPACT, NeuRA R.D Wright Biomedical Fellow, NHMRC

ASSOCIATE PROFESSOR SYLVIA GUSTIN Associate Professor, NeuRA & UNSW Director, Centre for Pain IMPACT, NeuRA Rebecca L. Cooper Medical Research Fellow, NeuRA & UNSW

PROFESSOR JAMES MCAULEY Senior Research Scientist and Group Leader, NeuRA Director, Centre for Pain IMPACT Professor, Faculty of Medicine and Health, UNSW Sydney

What else is happening in Back pain research at NeuRA?

FEEL THE BUZZ IN THE AIR? US TOO.

NeuRAustralia - A/Prof James McAuley on Low Back Pain (episode 38)

On August 11 2019, 54 people took on the City2Surf for Neuroscience Research Australia (NeuRA). The event is the world’s largest fun run with 80,000 participants taking on the 14km course, which stretches from Hyde Park in central Sydney to the iconic Bondi Beach. NeuRA thanks all of its fundraisers, who raised an incredible $30,903.  This funding will further NeuRA’s […]

Gabrielle Hunter
NeuRA BLOG: Team NeuRA at the City2Surf 2019

By age 85, one in three Australians will have dementia

Australians are living longer than before. But while our bodies might be staying healthy, our brains are not. Neurodegenerative diseases are on the rise and one in three Australians now have dementia at age 85. With no way of preventing, treating or curing it, dementia is set to overtake heart disease as a leading cause of death in Australia in less than 30 years.
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Back and Neck Pain Forum
Hypnosis transforming chronic pain treatment

Social Media for Low Back Pain

Social media is a potentially powerful tool to provide a message of education and reassurance to the general public about low back pain. This project will use social media to educate the general public about low back pain and promote self-management. The project involves three stages. Firstly, we will conduct a content analysis to gain an insight into social media users’ perceptions and understanding about low back pain. This could determine whether social media could serve as an educational tool through which accurate information related to low back pain could be disseminated to the public. Second, a recent Delphi survey of 150 low back pain researchers identified 30 key messages considered to be important for the general public to know about LBP. These statements provide evidence-based information on the diagnosis, prognosis and management of LBP and are intended to educate, reassure and promote self-management. We will investigate the attitude of the general public towards these messages. Third, working in conjunction with a media company Y&R, we will design and test a social media campaign to encourage self-management for people with low back pain.
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