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2021 Australian Pain Society 41st Annual Scientific Meeting

2021 Australian Pain Society 41st Annual Scientific Meeting In the IASP Global Year About Back PainConference: 19 - 20 April 2021 | Pre-Conference Workshops: 11 April 2021 | Virtual

Topical Session Outlines

Please click below for session outlines and confirmed speakers

 

Topical Sessions 1 - Monday 19 April 2021, 11.00 am - 12.15pm

Topical Sessions 2 - Monday 19 April 2021, 1.15 pm - 2.30pm

Topical Sessions 3 - Tuesday 20 April 2021, 11.15 am - 12.30pm

Topical Sessions 4 - Tuesday 20 April 2021, 1.30 pm - 2.45pm


Topical Sessions 1

Monday 19 April 2021, 11.00am - 12.15pm


1A: The art of clinical communication: Shaping patients’ emotions, beliefs and behaviours 

Chair: Dr Claire Ashton-James, University of Sydney, NSW

Clinical communication skills are essential to patient outcomes in chronic pain management. Clinicians’ ability to identify and manage patients’ fear, anger or distress influences patient engagement and receptiveness to treatment advice; the words that clinicians use to describe their clinical observations shape patients’ beliefs about their prognosis and functional limitations, and clinicians’ ability to simultaneously validate and challenge unhelpful beliefs is essential for creating “teachable moments” and long term behaviour change. This session brings together three of Australia’s leading experts on clinical communication in the context of chronic pain management. Dr Claire Ashton-James will present research indicating that the ability to manage patient emotions is associated with both clinician and patient wellbeing (treatment outcomes) and will demonstrate evidence-based strategies for de-escalating patient emotions using a combination of video footage and audience-based interactive role play. Drawing on findings from her research, Dr Bunzli will describe how the language used by clinicians can perpetuate negative beliefs and behaviours among patients. To assist clinicians in the audience to modify their language, Dr Bunzli will present a series of interactive videos modelling helpful and unhelpful messages in the clinical setting. Finally, Dr Caneiro will demonstrate how to use behavioural experiments as a way to elicit and challenge unhelpful beliefs and behaviours that contribute to pain related disability and distress. 

Speakers:
Dr  JP Caneiro, Curtin University, WA
Dr Samantha  Bunzli, University of Melbourne, VIC
Dr Claire Ashton-James, University of Sydney, NSW

1B: Food, mood, chronic pain and the microbiome

Chair: Dr Katherine Brain, University of Newcastle, NSW

We have tens of trillions microorganisms living inside our body which makes up 2 kilograms of our total body weight. How does this affect our health? How does this affect chronic pain? These are some of the questions this session will aim to answer.

This topical session will explore the complex relationships between food, mood, pain and the microbiome. The session will begin with Prof Mark Morrison discussing the basic science relationships between specific nutrients and the microbiome. Following this Dr Kerith Duncanson will explore the relationship between dietary intake, the microbiome and chronic pain including common gut disorders. The session will end with Dr Sarah Campbell outlining the relationship between emotional health and the microbiome. When does stress become a problem for the gut and what can you do about it?

Speakers:
Professor Mark Morrison, University of Queensland, QLD
Dr Kerith Duncanson, Univeristy of Newcastle, NSW
Dr Sarah Campbell, Hunter Pain Integrated Service, NSW

1C: Pelvic pain basics for the everyday clinician

Chair: Dr Jane Chalmers, University of South Australia, SA

Pelvic pain is a complex condition which can present in any clinical situation. This session presents a ‘pants on’ approach to pelvic pain and aims to equip the everyday clinician with the tools they need to start addressing pelvic pain with their patients.

Alison Sim will first share some tips and tricks on listening and talking to patients about pelvic issues. This will include a discussion on key information we should gather from pelvic pain patients and how to ask sensitive questions.

Second, Dr Jane Chalmers will explore some of the common presentations of pelvic pain in men and women, and discuss some of the basic ‘pants on’ assessment methods the everyday clinician can use with pelvic pain patients.

Dr Sandy Hilton will then describe some of the pelvic-related problems that may arise in pregnancy and provide practical options to address the problems, including self-treatment techniques to use during pregnancy and post-partum recovery.

Together, Alison, Jane, and Sandy will then present some of the latest, evidence-based, practical treatment ideas for the everyday clinician seeing a pelvic pain patient for the first time. This will also include audience involvement in practicing some interventions.

Speakers:
Ms Alison Sim, Pain Matrix, VIC
Dr Jane Chalmers, University of South Australia, SA
Dr Sandy Hilton, Entropy Physiotherapy, USA

1D: Project ECHO: a shout out to our pain colleagues

Chair: Professor Fiona Blyth, Sydney School of Public Health, University of Sydney, NSW

This session will introduce Project ECHO to Australian pain clinicians. Project ECHO utilises virtual professional educational clinics to upskill and support primary care clinicians in their management of complex conditions such as persistent pain. This hub and spoke model connects multidisciplinary subject matter experts (the hub) and multidisciplinary primary care clinicians (the spokes) with each other. Brief didactics are presented by a hub member at each session followed by a discussion of a complex case put forward by one of the spoke participants. The session is concluded with a summary of the suggested management plan. Spokes attend for one or two series of ECHOs, which may be delivered weekly, fortnightly or monthly.

This topical session will engage participants with a series of short talks on what Project ECHO involves, a discussion of the evidence related to the outcomes of existing ECHOs including those on persistent pain and the development and evaluation of Australia’s first adult persistent pain ECHO, currently running out of the Western Victoria Primary Health Network. The second half of the topical session will be a live Project ECHO session featuring members of the WVPHN Hub and Project ECHO team from the University of New Mexico (time zone permitting).

Speakers:
Dr Anne Daly, WorkSafe Victoria and the Transport Accident Commission, VIC
Dr Simone De Morgan, Menzies Centre For Health Policy, University of Sydney, NSW

1E: Persistent Pain following Spinal Cord Injury: Prevalence, Practice, and Progress

Chair: Dr Daniel Harvie, Griffith University, QLD

Spinal Cord Injury (SCI) is often followed not only by impairment of function, but also persistent pain, fatigue and psychological disturbances that limit community participation. In this topical session, we will present the current state of play with respect to epidemiology, mechanisms, and management of pain following SCI. Prof. James Middleton will present the latest data from a large Australian survey of pain in people with SCI (n=1579) in terms of prevalence, lived-experience, associations with other secondary conditions, including sleep disorder, mood disturbance and fatigue, impact on quality of life and current self-reported interventions. Assoc. Prof. Sylvia Gustin will present data relating to virtual reality treatment for SCI while discussing potential brain mechanisms responsible. In addition the discovery of a third category of SCI – discomplete SCI – and it’s relevance to rehabilitation will be examined. Finally, Prof. Ashley Craig will discuss a new model of the relationship between pain, fatigue, depressive mood and self-efficacy in SCI and recent findings on “top down” versus “bottom up” pain related factors and their influences on fatigue and sleep in adults with SCI.

Speakers: 
Professor James Middleton, University of Sydney, NSW
Associate Professor Sylvia Gustin, Neuroscience Research Australia, NSW
Professor Ashley Craig, University of Sydney, NSW

 

Topical Sessions 2

Monday 19 April 2021, 1.15pm - 2.30pm


2A: Early Psychosocial Intervention for Injured workers: Challenges and Benefits

Chair: Dr Manasi Mittinty, University of Sydney, NSW

Individuals sustaining work-related injuries are at an increased risk of chronic pain, long term disability, as well as impaired mental and physical health. Prolonged absence from work also increases their risk of never returning to work. Most of those at greater risk of these poor outcomes can be identified within a few weeks of their injury, making prevention a real possibility.

 The Exploration, Preparation, Implementation, Sustainment framework (EPIS) has been endorsed for the conceptualisation and planning of interventions for injured workers. One of the key domains identified by EPIS is involvement of the workplace/employers with enhanced recovery, reduced costs and faster return to work reported.

Speakers:
Professor Michael Nicholas, University of Sydney, NSW
Mrs Melanie Ianssen, Australia Post, VIC
Dr Manasi Mittinty, University of Sydney, NSW

2B: First line non-pharmalogical care for managing acute pain: A person-centred approach to translating evidence to practice

Chair: Dr Jeffrey Mott, Redcliffe Hospital, QLD

About 90% of surgical patients suffer from post-operative pain[1], and over 40% of patients on medical wards requires pain management[2]. Despite the willingness of patients to use non-pharmacological interventions to facilitate post-operative recovery[3], care remains focused on the use of medicines. While opioids may be indicated, side effects include post-operative nausea and vomiting, sedation and respiratory depression and prolonged hospital stay.

A range of safe and effective non-pharmacological (physical and psychological) interventions are included in “Acute Pain Management: Scientific Evidence”[2] compiled and updated by the Faculty of Pain Medicine, Australian and New Zealand Colleges of Anaesthetists. Those interventions contribute to the acute pain care toolkit. Raising consumers and health professional awareness of such contemporary evidence-based care components may help to reduce the reliance on medicines alone and guide the implementation of effective multimodal, low cost and safe acute pain care.

In this workshop, we will present evidence contextualised with clinical cases, to illustrate ‘what’ and ‘how’ non-pharmacologic care can be enabled and integrated to support acute pain care and promote active recovery.

Speakers:
Professor Helen Slater, Curtin Univeristy, WA
Associate Professor Zhen Zheng, RMIT University, VIC
Dr Allyson Browne, Curtin University, WA

2C: Unravelling the mechanisms of migraine: from brain imaging to genetics

Chair: Professor Luke Henderson, University of Sydney, NSW

Migraine is a severe, disabling neurological disorder and its mechanisms are poorly understood, resulting in poor treatment options for patients. In this topical session we will discuss multiple mechanisms of migraine and discuss the implications for treatments. A/Prof Seminowicz will discuss the effects of migraine on cortical cognitive networks and how mindfulness meditation as an intervention can reduce migraine frequency and increase cognitive efficiency. Dr. Meylakh will present functional MRI data measuring hypothalamic brainstem connectivity and explore how a dysfunctional hypothalamic network may underlie migraine initiation and expression. Dr. Sutherland will present on the role that ion channels play in migraine using next generation sequencing technologies. Thus, the mechanisms covered will range from large scale brain networks down to molecules.

Speakers:
Associate Professor David Seminowicz, Neuroscience Research Australia, NSW
Dr Heidi Sutherland, Queensland University of Technology, QLD
Dr Noemi Meylakh, University of Sydney, NSW

2D: Thinking outside of the box

Chair: Associate Professor Tasha Stanton, University of South Australia, SA

Prepare to be dazzled. This session will bring together world-class speakers from a variety of research backgrounds to explore what we do right, what we do wrong, and what we could do better.

Doctor Fiona Kerr, trained in complex systems engineering and cognitive neuroscience (augmented by degrees in psychology and anthropology), will explore the future landscape of pain treatment given advances in both Artificial Intelligence (AI) and our understanding of the neurophysiological impacts of human connection. She will discuss the critical considerations that are needed to use AI to its potential given the extensive positive neural and biological changes brought about by warm interaction (e.g., touch, gaze, empathic dialogue).

Associate Professor David Butler, a pain communication expert and learning enthusiast, will then question why any of us are attending this conference if we don’t even know how to learn. He will explore what it means to learn, specifically discussing whether our patients might be victims of our learning experiences as clinicians and what we can do to change that.

Last, Dr Hannah Brown, an expert research-communicator who previously led Storytelling, Communication, and Development at the South Australian Health and Medical Research Institute (SAHMRI) will walk us through science communication, namely how we can develop a narrative and use storytelling to help convey complex or difficult concepts to a variety of audiences.

Speakers:
Professor Fiona Kerr, NeuroTech Institute, SA
Associate Professor David Butler, University of South Australia, SA
Associate Professor Hannah Brown, Victorian Heart Institute, Monash University, VIC

2E: From hysteria to silent epidemic: The modern story of chronic pelvic pain

Chair: Dr Ksenia Katyk, Hunter Integrated Pain Service, NSW

From the diagnosis of hysteria to suffering in silence: 1 in 5 young women throughout the world suffer dysmenorrhea sufficiently severe to miss school or work. A proportion of these will develop persistent pelvic pain. A proportion will become opioid dependent. Many of these women will later present to adult pain clinics with additional pain conditions. All will suffer diminished quality of life and significantly limited life opportunities. This session will provide the view of world renowned gynaecologists and specialists in pain medicine and patient advocates on the current topics, including latest management, prevention and advocacy including a panel discussion.

Severe dysmenorrhea offers the opportunity for the prevention of persistent pain. In treating these patients, it allows us to recognise women at risk at a young age and offer interventions to reduce the impact of pain on our society. This session considers the mechanisms and the interventions available, both current and future, across the sociopsychobiomedical spectrum to prevent persistent pelvic pain in women.

We will explore the place of endometriosis in pain and menstruation as an inflammatory process. We will discuss the role of surgery, illustrated by recent 10year follow up data from Royal Children’s Hospital, VIC, in adolescents and also adult women.

Pelvic Pain Foundation Australia created PPEP Talk® (Periods, Pain and Endometriosis Program) to empower young people with knowledge about period pain, pelvic pain, and endometriosis to improve their knowledge of their bodies and help them take care of their mental and physical health. This session will explore the ways we discuss pain with young people and how we educate a new generation of young people about their bodies.

Speakers:
Dr Susan Evans, Pelvic Pain Foundation, SA
Dr Sonia Grover, Royal Children's Hospital, VIC
Mrs Libby Parker, Expressions Media, SA

 

Topical Sessions 3

Tuesday 20 April 2021, 11.15am - 12.30pm

3A: Pain Revolution four years in. Updates, challenges and opportunities

Chair: Dr Carolyn Berryman, University of Adelaide, SA

The purpose of pain revolution is to reduce the incidence, prevalence and impact of persistent pain in rural and regional Australia and its vision is that all Australians will have the knowledge, skills and local support to prevent and overcome persistent pain. In this topical symposium, we will present the reason for Pain Revolution, its guiding principles and the theoretical frameworks and evidence base that underpin all its strategies. We will outline the various Pain Revolution strategies, including the Local Pain Educator program, the Local Pain Collectives project and the Community Engagement Project, all of which have involved collaboration with and funding from several government agencies and community groups. We will give an overview of the Pain Revolution Rural Outreach Tour, for which the Australian Pain Society is an ongoing Association Partner. We will present preliminary evaluations. Finally, we will provide an ‘on the ground’ case study from one of the communities which has been impacted by these strategies. This symposium will be a frank appraisal of a work in progress, including successes, failures, the barriers to progress and our attempts thus far to overcome them. There will be time for questions and discussion on how to get involved.

Speakers:
Dr Carolyn Berryman, University of Adelaide, SA
Professor Lorimer Moseley AO, University of South Australia, SA
Mr Daniel Searle, Pain Revolution, VIC

3B: Understanding pain mechanisms and implementing meaningful pain assessment for children with cerebral palsy

Chair: Dr Simon Paget, Children's Hospital at Westmead, NSW

Chronic pain is common in children with cerebral palsy (CP), yet it is not well understood, is under-identified and poorly managed in this population. Measurement tools that can adequately identify and measure pain in this medically complex and heterogeneous group are underutilised and tool selection is complicated by varying abilities of children and adolescents to self-report pain across a spectrum of disability and ages. Many are unable to self-report due to cognitive and/or communication limitations. Additionally, the biopsychosocial pain model is not adequately considered within current pain measurement practices in CP, causing poor understanding of the multi-dimensional nature of pain in these children.

Speakers:
Dr Angie Morrow, Murdoch Childrens Research Institiute, VIC
Associate Professor Adrienne Harvey, Murdoch Childrens Research Institiute, VIC

Ms Nadine Smith, Perth Children's Hospital, WA

3C: Meanings of Cancer-Related Pain

Chair: Professor Jane Phillips, University of Technology Sydney, NSW

Cognitive factors are important determinants of cancer-related pain experience. Simon van Rysewyk describes how cancer-related is particularly sensitive to cognitive factors and describes some common cognitions that people with cancer-related pain have and how they influence patient outcomes. Xiangfeng Xu (Renee) presents on the cultural and social factors that influence cancer pain management of Chinese migrants and what culturally congruent strategies may be implemented to improve their pain outcomes. Melanie Lovell compares levels of suffering in people with cancer-related pain versus non-cancer chronic pain, highlighting differential meanings of existential or spiritual distress and mood dysfunction. Lovell outlines management approaches to cancer pain and suffering that are not responsive to analgesia, such as meaning- or peace-centred therapies.

Speakers:
Dr Simon van Rysewyk, Univeristy of Tasmania, TAS
Dr Reene Xu, University of Technology Sydney, NSW
Associate Professor Melanie Lovell, Hammond Health Sydney North, NSW

3D: Pain Management in aged care in a post-Royal Commission and post-Covid-19 world

Chair: Associate Professor Benny Katz, St Vincent's Hospital, VIC

Recent events have significantly impacted the aged care sector. A Royal Commission into Aged Care Quality and Safety was established to inquire on the standard of aged care services in Australia. And the impact of the Covid-19 pandemic has likewise had a profound impact on aged care services.

In this session, we will explore pain in aged care during and after the covid-19 pandemic in the context of the recent findings of the Royal Commission. We will discuss recently exposed challenges in pain management, as well as discuss pragmatic solutions and identify future opportunities.

Assoc Prof Benny Katz will talk about aged care in the midst of the Royal Commission and Covid-19. Professor Joseph Ibrahim will talk about how the challenges of pain management in aged care may be indicative of a greater malaise in aged care services. Ms Marie Vaughan will discuss what these recent experiences have taught us about training and resource allocation in aged care, and what are the pragmatic opportunities to improve pain management. Dr Steven Savvas will talk about recent and future new initiatives for pain management in aged care services.

Speakers:
Associate Professor Benny Katz, St Vincent's Hospital, VIC
Professor Joseph Ibrahim, Monash University, VIC
Ms Marie Vaughan, Department of Health and Human Services, VIC
Dr Steven Savvas, National Ageing Research Institute, VIC

3E: Predicting pain outcome: from biomarkers to interventions

Chair: Dr Siobhan Schabrun, Neuroscience Research Australia, NSW

The identification of factors that can predict who will get better after an episode of acute pain and who will develop long-term pain and disability is essential for the development of new interventions. This workshop presents new insight into factors that can predict acute pain outcome. The first presentation will discuss cortical (EEG and TMS) biomarkers that have been shown to predict pain outcome following surgery and an episode of musculoskeletal pain. The second presentation will highlight findings from the recently completed UPWaRD longitudinal study of predictive and causal mechanisms in the transition from acute to chronic low back pain including evidence for the role of neurophysiological, genetic, inflammatory and psychosocial factors. The workshop will conclude with discussion of interventions (e.g. nicotine, non-invasive brain stimulation) that can modulate these factors and can be used to design individualised, targeted interventions for chronic pain.

Speakers:
Associate Professor David Seminowicz, University of Maryland, USA
Mr Luke Jenkins, Western Sydney University, NSW
Dr Siobhan Schabrun, Neuroscience Research Australia, NSW


Topical Sessions 4

Tuesday 20 April 2021, 1.30pm - 2.45pm

4A: A strategic approach for upskilling the Australian health workforce to deliver effective, evidence-based care for chronic pain patients

Chair: Dr Duncan Sanders, PMRI, University of Sydney, NSW

The National Strategic Action Plan for Pain Management (2019), identified as a key goal the need for ‘health practitioners who are well informed on best practice evidence-based assessment and care and supported to deliver this care’. In support of this goal, the Commonwealth Government (within the Public Health and Chronic Disease program) has funded two grants: one to develop a Health Practitioner Education Strategy (over 18 months) and the other to develop and provide pain management training and educational resources for health professional to more effectively deliver pain management care (over 4 years). The Faculty of Pain Medicine is leading the development of the Education Strategy grant, and a Consortium of Universities and peak bodies, led by the Pain Management Research Institute, is leading the development of the training opportunities and educational resources grant.

This topical workshop outlines the plans and issues being addressed by the pain management training grant. The session will highlight the key issues, aims, strategies and proposed methods for operationalising the planned grant outcomes. It also provides an opportunity for attending health professionals to discuss and provide feedback to the consortium on the proposals.  

Speakers:
Dr Michael Nicholas, PMRI, University of Sydney, NSW
Dr Helen Slater, Curtin University, WA
Dr Elizabeth Devonshire, PMRI, University of Sydney, NSW

4B: Engaging different populations in pain-related education 

Chair: Dr Joshua Pate, University of Technology Sydney, NSW

This topical session features interdisciplinary perspectives on how clinicians, researchers and educators can engage different populations in pain-related education.

Senior Physiotherapist and Lecturer Dr Joshua Pate will describe a novel approach to large-scale pain-related education by working with TED-Ed and YouTube to disseminate educational animations about pain science. Professor Julia Hush will explain how the International Association for the Study of Pain (IASP) pain curriculum can be embedded into a tertiary physiotherapy course, and how curriculum modules can be connected across different health disciplines. Senior Lecturer Dr Hazel Jenkins will explore the barriers General Practitioners face providing patient education for acute low back pain, and how to introduce new education material for General Practitioners to use with patients in clinical practice.

Speakers:
Dr Joshua Pate, University of Technology Sydney, NSW
Dr Hazel Jenkins, Macquarie University, NSW
Dr Julia Hush, Macquarie University, NSW

4C: What hurts us makes us closer: The relationship between pain and social connection 

Chair: Dr Dianne Wilson, University of South Australia, SA

The social antecedents and consequences of acute and chronic pain are often underrepresented in pain management and pain research. Accordingly, very little is done to harness social modulators of pain to improve patient outcomes. The goal of this session is to examine the association between pain and social connectedness and consider the implications of these research findings for the treatment of pain. Dr Claire Ashton-James will open the session by presenting evidence that people seek out and create social bonds with others in anticipation of acute pain experiences, and that the experience of low levels of acute pain increase prosocial attitudes and behaviour towards minorities. Consistent with these findings, Dr Laura Ferris presents field research into the association between the "pleasurable" pain of swimming naked in ice-cold water during Hobart's Dark Mofo Festival and identification with others. Finally, Di Wilson will present the results of her PhD research into the contribution of group identification and sense of belonging to outcomes in group CBT-based pain management programs.

Speakers:
Dr Claire Ashton-James, PMRI, University of Sydney, NSW
Dr Laura Ferris, University of Queensland, QLD
Dr Dianne Wilson, University of South Australia, SA

4D: Pain and the immune response

Chair: Associate Professor Jason Ivanusic, University of Melbourne, VIC

Chronic inflammation is a significant source of pain that is presented in many different ways including in conditions of global importance such as osteoarthritis and fibromyalgia. It is difficult to manage and poorly understood at the cellular/molecular level, and hence, understanding how inflammation and immune cells drive pain responses may lead to the identification of new therapeutic targets and treatment strategies. This topical session incorporates basic pain and clinically-focussed researchers to provide new insights into cellular processes that drive inflammation and pain, and reveal new strategies that may help to combat inflammation and neuroimmune functional interactions.

Speakers:
Associate Professor Irina Vetter, University of Queensland, QLD
Associate Professor Gila Moalem-Taylor, University of New South Wales, NSW
Professor John  Hamilton, Royal Melbourne Hospital, VIC
Professor Geoff Littlejohn, Monash University, VIC

4E: “Talkin with white fellas…is a pain”: clinical yarning to overcome barriers to health professionals communicating with Aboriginal and Torres Strait Islander patients with chronic pain.

Chair: Associate Professor Paul Gray, Royal Brisbane & Women's Hospital, QLD

The experience of chronic pain and its management require collaborative exchanges between patients and their health professionals. Advancements in pain management will not benefit Aboriginal and Torres Strait Islander peoples unless communication between health professionals and their patients improves.

This presentation introduces the study protocol, discusses how the training challenges western approaches to communication and explores the benefits of adopting a culturally sensitive approach to reorient and improve health professionals’ communication.

Speakers:
Mr Jermaine Isua, Queensland Health, QLD
Dr Matthew Bryant, North Queensland Persistent Pain Management Service, QLD
Dr Ivan Lin, University of Western Australia, WA