The International Association for the Study of Pain (IASP) defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage”. Acute pain is the pain that says you’ve been hurt. It is often temporary and begins suddenly, often as a result of injury or inflammation. Sensory inputs from damaged tissue project via specific nerve fibres (nociceptors) to the brain, which generates a perception of pain – the quality of which depends on the tissue of origin. Reflex responses to a painful stimulus serve to protect the body from further damage: superficial pain – that originating in the skin – leads to withdrawal of the body part from the stimulus, whereas deep pain – that originating in muscle, for example – leads to protective responses that limit further damage to the injured body part.
Pain might be mild and last just a moment, or it might be severe and last for weeks or months. As the body repairs the damage the nociceptive messages cease, encouraging use of the injured or inflamed body part once again. It is important to get moving again as over-protection of an injury or under-use of a limb may lead to further complications.
Things that will help pain to feel better include making changes to exercise, where appropriate – so if running has caused an injury, switch to cycling or swimming; treat the injury with therapy, such as physical therapy, occupational therapy or massage therapy; or try meditation or deep relaxation techniques that aim to relax each part of your body or help manage pain.
In most cases, pain does not last longer than three months, and it disappears when the underlying cause of pain has been treated or has healed. Unrelieved pain, however, might lead to chronic pain. Chronic pain is considered to be pain that lasts for three months past the point of injury, and it is now generally accepted that changes in the brain are responsible for maintaining the pain long after the nociceptive signals of tissue damage have stopped.
Researchers: Associate Professor Sylvia Gustin, Nell-Norman-Nott, Dr Negin Hesam- Shariati, Dr. Chelsey Wilks (University of Washington).
Emerging evidence has shown that negative emotional states play a key role in the development and maintenance of chronic pain. The No Worries Trial will evaluate the effectiveness of a four-week internet-delivered Dialectical Behaviour Therapy (DBT) skills training to help chronic pain sufferers cope with painful, fearful, worrisome, anxious, and negative thoughts and emotions. Moreover, by having the DBT skills training online it is more accessible to those in remote communities, to those with restricted mobility, and more broadly it adds to the knowledge of internet-delivered therapies at a time when online is increasingly necessary to deliver treatment due to COVID-19.
Complex Regional Pain Syndrome (CRPS) is a serious health condition, affecting approximately 20,000 people in Australia. It is characterised by severe burning, stinging and stabbing pain. People with CRPS are unable to use their painful limb and their ability to work or participate in normal social activities is severely restricted. Currently, there are no effective treatments for CRPS.
A vast body of research has demonstrated changes in brain processes in CRPS. The MEMOIR trial will investigate the effectiveness of two novel brain-directed treatments to reduce pain and improve function in people with CRPS.
MEMOIR consolidates the expertise of scientists and clinicians from NeuRA (A/Prof James McAuley, A/Prof Sylvia Gustin, Mr Michael Ferraro), the University of South Australia (Prof Lorimer Moseley), the University of Sydney (Prof Andrew McLachlan), the University of Notre Dame Australia Fremantle (Prof Benedict Wand, Prof Eric Visser), the University of Exeter (Prof Sallie Lamb), Brunel University London (Dr Neil O’Connell) and the University of Oxford (Dr Hopin Lee).
Due to the COVID-19 global pandemic, the commencement of MEMOIR has been delayed. Recruitment for MEMOIR will commence in September 2020.
If you are interested in being contacted about our CRPS research, please leave your details below and we will be in touch once recruitment begins.
Chronic neuropathic pain (NP) can be a debilitating secondary condition for persons with spinal cord injury (SCI) and effective pharmacological and non-pharmacological treatments remain elusive. This project brings together international experts in basic science and clinical approaches to SCI NP for a rigorous multisite randomized clinical trial to examine the efficacy and mechanisms of an advanced interactive virtual reality (VR) walking intervention (VRWalk).
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.
People in pain move differently. Yet, the biological basis for altered movement in pain is poorly understood. This lack of understanding has led to treatments for persistent pain that target generic symptoms with limited effect. This NHMRC-funded trial is the first to examine how different aspects of the nervous system are altered in pain and how this relates to movement. This information will guide the development of new treatment strategies for persistent pain in future.
Persistent musculoskeletal pain is one of the most significant health issues in the developed world. Termed a ‘Western epidemic’, low back pain is the most common form of persistent musculoskeletal pain and a leading cause of suffering and disability. Despite the enormity of the problem, many current therapies target generic symptoms, not underlying mechanisms, with limited effect. In 2010, the Australian National Pain Summit concluded ‘the management of pain is shockingly inadequate’. This assessment is not surprising given that critical information on the biological changes that underpin persistent low back pain is lacking. The UPWaRD study is a 5-year NHMRC-funded trial that investigates the role of brain plasticity, along with biological changes in the spinal cord, hormonal changes, genetics and stress, in the development of persistent low back pain.
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:
Medicines for Back Pain – Publications:
Medicines for Back Pain – Registrations of Study Protocols:
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.
Chronic pain, defined as pain lasting for >3 months, typically develops from injuries to deep tissues such as muscle, yet little is known about how long-lasting pain affects a person’s blood pressure or capacity to control their muscles. This project assesses the effects of tonic muscle pain on sympathetic nerve activity and stretch sensitivity of muscle spindles.
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 […]