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Research Projects

HeLP for pain – Healthy Lifestyle for Painful conditions

Project Summary

Painful conditions such as chronic pain, low back pain and osteoarthritis are linked with unhealthy lifestyle risks such as smoking, inactivity, unhealthy diet, poor sleep and increased weight. All of these factors often interrelate, where the pain and disability can cause lifestyle changes and the lifestyle change increase the pain. For this reason, people with pain and unhealthy lifestyles often have high rates of chronic health problems. Despite this very little research has focussed on finding out how best to support people with chronic painful conditions and lifestyle risks. This program aims to understand how lifestyle risks and pain are connected, and the best strategies that support people with pain and lifestyle challenges to manage their health.

Our Investigators

  • Associate Professor Chris Williams
  • Dr Simon Davidson
  • Dr Eduardo da Silva
  • Professor Vicki Flood
  • Amanda Tutty
  • Jane Linton

Collaborators

  • Professor Steven Kamper, University of Sydney and Nepean Blue Mountains Local Health District
  • Professor James McAuley, Neuroscience Research Australia
  • Professor Anne Tiedeman, University of Sydney
  • Dr Aidan Cashin, University of New South Wales
  • Dr Robin Haskin, John Hunter Hospital
  • Professor Luke Wolfenden, University of Newcastle
  • Dr Emma Robson, University of Newcastle

Partner organisations

  • Mid North Coast LHD
  • Hunter New England LHD
  • Northern NSW LHD
  • Nepean Blue Mountains LHD
  • Agency for Clinical Innovation
  • HCF Foundation

Status/timing

The program was initiated in 2016 and is ongoing.

What did/does the Project do/focus on?

Chronic pain condition like low back pain and osteoarthritis affects more than 4 million (1 in 5) Australians. These are the leading causes of early retirement and cost the economy nearly 50 billion per year. 

The programs aims to understand:

  1. The extent to which lifestyle risk influences pain, and how pain influences lifestyle risk and chronic disease.
  2. If treatments, or combinations of treatments, that focus of lifestyle change can reduce the impact of pain and disability.
  3. How to increase the capacity of health care to support people with comorbid lifestyle risks and painful conditions.

Our initial studies included systematic reviews involving millions of people. We also assessed around 1000 local patients and monitored their health over 5 years. We found that although people with chronic pain have higher rates of lifestyle risk and subsequent chronic disease, only about 10% of these people are provided with support to address these. Many of these people are referred for treatments that have limited benefits, and they might wait on public hospital waiting lists for years, without support. This understandably made them feel ‘left in the lurch’ and they reported that their health suffered.

What type of project/study?

The program consists of several randomised controlled trials, systematic reviews and observational cohort studies.

Initial findings

Our initial studies included systematic reviews involving millions of people. We also assessed around 1000 local patients and monitored their health over 5 years. We found that although people with chronic pain have higher rates of lifestyle risk and subsequent chronic disease, only about 10% of these people are provided with support to address these. Many of these people are referred for treatments that have limited benefits, and they might wait on public hospital waiting lists for years, without support. This understandably made them feel ‘left in the lurch’ and they reported that their health suffered. 

Our studies have found:

  1. Many people receive information and care that is of little benefit and in some cases harmful. This reality increases for those located in rural areas. 
  2. Many people are referred for surgery, even though they have been offered less invasive and recommended options first.
  3. People who have an episode of low back pain often to attend emergency departments because accessing a GP is challenging.
  4. People with osteoarthritis and back pain, have a higher risk of developing cardiovascular disease, likely due to declining activity levels over time and other 
  5. Focusing on improving lifestyle habits in pain management care, empowers people to self-manage their pain more than otherwise usual care. This in turn leads to improved pain and disability from back pain and osteoarthritis. 

What do you expect to achieve with this project when complete?

The program targets a number of national and international issues:

Our work for the WHO showed that there wasn’t enough evidence on lifestyle care for low back pain for the WHO Global Guideline on Low Back Pain to recommend this be common practice. Our new trials will provide world leading evidence to inform new recommendations. 

Although the National Pain Strategy recommends people who suffer from chronic pain receive ‘integrated care’ that optimises the multiple aspects of their health, there is little understanding about how to increase access to such care in Australia. Our implementation studies aim to reveal the best ways to ensure people receive the support they need.

Notable insight? Unexpected direction?

There is never one cause of pain, but there are many so-called magic solutions available (to purchase). Amongst all of that noise, the challenge many people have is uncovering the many possible causes of their pain, and designing a management plan that will work for them.