17-20 March 2013 | National Convention Centre, Canberra, ACT, Australia

Topical Sessions 1

1A

A multidisciplinary approach to headache management

Chair: Professor Michele Sterling, Centre of National Research on Disability and Rehabilitation Medicine, University of Queensland, QLD

A multidisciplinary panel will discuss approaches to the management of headache. Participants will understand the current knowledge and evidence base of the management of headache and the integration of medical, psychological and physical approaches to the management of various headache types.

Presenters:

Dr Paul Verrills, Metro Spinal Clinic, VIC

Dr Stuart Cathcart, University of Canberra, ACT

Mr Ken Niere, La Trobe University, VIC

 

1B

Pain representation in the human brain

Chair: Professor Lorimer Moseley, University of South Australia, SA

Interest in pain and the brain is understandably intense. Contemporary imaging tools have made it possible to test associations between pain and brain structure and function, fuelling a burgeoning literature of pain imaging studies. This body of research has produced important insights into the representation of pain in the brain.

However, the inherent complexity of the subject matter combined with arcane experimental procedures and analysis techniques can make outcomes from brain imaging studies difficult to understand. The purpose of this topical session is to provide delegates with a framework with which to make sense of pain imaging research.

Dr Michael Farrell will speak about brain imaging techniques and the type of conclusions that can be drawn from the most common experiments.

Dr Katja Wiech will draw upon her research outcomes to illustrate how imaging can implicate brain processes in the nexus between beliefs and pain experience.

Professor Lorimer Moseley will discuss a conceptual model of pain that integrates what the pain imaging research has helped us to understand in a way that can be applied to our clinical approach to people in pain.

Presenters:

Dr Michael Farrell, Florey Neuroscience and Mental Health Institute, VIC

Dr Katja Wiech, Oxford Neuroscience, UK

Professor Lorimer Moseley, University of South Australia, SA

 

1C

Chronic pain across the ages: cultural, family and caregiver implications

Chair: Dr Matthew Crawford, Department of Pain and Palliative Care, Sydney Children’s Hospital, NSW

It is important to determine factors that are associated with age-related differences in chronic pain within the context of both health and environmental variables. Furthermore, it must be recognised that child to adult transitions in health care involves not only clinical changes, but also systemic and cultural changes. This session will review important features of the chronic pain experience, behaviours and management across the ages from children to older adults, with particular focus on the influences of family and caregivers including cultural influences.

Fiona Blyth will set the temporal perspective by reviewing the developmental origins of health and chronic diseases, emerging evidence from life course studies about the life course of chronic pain, and the potential gains from interventions early in life to prevent or mitigate the adult burden of chronic conditions.

Marianne McCormick will present the paediatric perspective on chronic pain, its implications for adult life, and the bidirectional influences between children and adolescents and their parents, siblings and peers. Multidisciplinary management issues specific to paediatric chronic pain will be reviewed.

Jordan Wood will discuss some of the key challenges patients, families and health systems face during transition from paediatric to adult services in order to maximize potential and quality of life. Winnie Hong will highlight the complex biological, social and cultural factors that are particular to older adult people with chronic pain and the special issues in management.

Presenters:

Assoc Prof Fiona Blyth, Concord Clinical School, University of Sydney, NSW

Mrs Marianne McCormick, Allied Health Department, Sydney Children’s Hospital, NSW

Dr Jordan Wood, Department of Anaesthesia and Pain Medicine, Sydney Children’s Hospital, NSW

Dr Winnie Hong, Multidisciplinary Pain Clinic, Concord Repatriation General Hospital, NSW

 

1D

Towards pragmatic multi-axial labelling and management planning in pain medicine

Chair: Ms Jane Muirhead, Pain Care, WA

Although chronic pain is now conceptualised in a biopsychosocial framework, our diagnostic language - and therefore our formulation of management - does not reflect that. None of the three current nosological taxonomic systems (ICD-10, DSM-IV, IASP) captures the complex diagnostic dimensions of the patient presenting with chronic pain.

In an attempt to fill gaps in these systems, clinicians have invoked unproven bodily pathology as well as hypothetical psychopathology, and have ignored the social dimension. These attempts have been scientifically and clinically unsatisfactory.

The presenters will address the inherent problems in current nosology, will offer a rational biopsychosocial-based nomenclature taking a lead from DSM-4 and introduce a triaxial adaptation of ICD-10 for the purpose of clinical problem solving and management.

Presenters:

Dr John Quintner, Pain Medicine Unit, Fremantle Hospital, WA

Associate Professor Milton Cohen, St Vincent's Campus, NSW

Dr Graham Wright, Complex Injury Group, SA

 

1E

Implementing an entry-stage group information session for clients referred to attend a pain rehabilitation service: a Victorian experience

Chair: Ann Yeomanson, Eastern Health, VIC

Within the Specialist Pain Service settings, several scientific publications have proposed the use of group client entry sessions prior to 1:1 appointment allocation. Arguably the most significant impetus to explore the care value of such sessions is lengthy wait times.

Multiple potentially achievable positive client and service outcomes can be hypothesised including: Faster client access to early (if broad) clinical advice, face-to-face pain neuroscience education and service information beyond a brochure or referral intake phone conversation; and, Greater sustainability of services through elimination from the waitlist of clients not meeting service attendance policy, reduced reliance on 1:1 appointments where client neuroscience education occur and the creation of a forum for medically appropriate clients to request progress directly to further group programs rather than await a 1:1 appointment program.

This session includes an entry-stage group information session package implemented within a large Melbourne Public health network, highlights the efficient outcomes achieved since implementation, and welcomes an interactive discussion of the practical challenges and rewards encountered.

Presenters:

Ann Yeomanson, Eastern Health, VIC

Sue Yencken, Eastern Health and Cabrini Health, VIC

Paul Beaton, Deakin University, VIC

 

1F

Quirky clinical conundra

Chair: Dr Geoffrey Speldewinde, Capital Rehabilitation and Pain Management Centre, ACT

Have you ever had an experience in your pain practice that you would have loved to share with others? In this novel and unique session, a panel of presenters will discuss their weird and wonderful experiences and cases including diagnostic difficulties and things that compel you to think laterally.

The presenters will share their conclusions, noting their case may be ongoing without a definite conclusion by the time of the presentation. Discussion from the audience is sought and welcome.

 

 

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