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, with several reviews, clinical trials and implementation studies being finalised, underway and planned.
What did/does the Project do/focus on?
Chronic pain conditions like low back pain and osteoarthritis affect more than 4 million (1 in 5) Australians. These conditions are the leading causes of early retirement and cost the economy nearly $50 billion per year.
The programs aims to understand:
- The extent to which lifestyle risk influences pain, and how pain influences lifestyle risk and chronic disease.
- If treatments, or combinations of treatments, focusing on lifestyle change can reduce the impact of pain and disability.
- How to increase the capacity of health care services to support people with comorbid lifestyle risks and painful conditions.
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 risks and subsequent chronic diseases, only about 10% of these people are provided with support to address these. Many are referred for treatments that have limited benefits, and they might stay 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:
- Many people receive information and care that is of little benefit and in some cases harmful. This is more prevalent in regional and rural areas.
- Many people are referred for surgery, even though they haven’t been offered less invasive and more recommended options first.
- People who have an episode of low back pain often to attend emergency departments because accessing a GP is challenging.
- People with osteoarthritis or back pain have higher risks of developing cardiovascular diseases, which is likely due to declining activity levels and other lifestyle associated risk factors.
- When people focus on improving lifestyle habits in pain management care, they become empowered to self-manage pain more than other usual care. This in turn leads to a reduction in pain and improved disability.
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 particularly for weight management, for low back pain. Because of this the WHO Global Guideline on Low Back Pain cannot recommend this be common practice. There is also no evidence of other lifestyle care such as support for smoking cessation available.
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 that can be misleading. Amongst all that noise, the challenge can be uncovering the variouspossible causes of their pain, and designing a management plan that will work for them.
