Chronic pain: is cure a step too far?

Chronic pain: is cure a step too far?

Principal speaker

Professor Kathryn Refshauge

Menzies Health Institute Queensland Lecture

Abstract

Pain is a universal experience. Chronic pain is not. Despite the investment of many millions of dollars in investigations of chronic musculoskeletal pain, particularly low back pain, we are apparently no closer to solving the enigma of why some people develop chronic pain while others recover from an acute episode. Effective treatments are seemingly illusory: most have small effect sizes, or moderate effect size at best. Cure is rarely, if ever, mentioned. Does this suggest there is no cause for hope for people with chronic low back pain?

The efforts of researchers and clinicians have shifted from essentially physical interventions to essentially psychological interventions, and now incorporate both. These changes are apparently subject to fashion, and led by researchers. So where in this journey of discovery is the patient? - or the clinician?

Together with her team, Professor Refshauge has conducted many of these studies. Findings are generally unrewarding, so Professor Refshauge is seeking to shift the paradigm, and trial new approaches to the diagnosis and treatment of chronic pain, specifically chronic pain originating in the musculoskeletal system with the aim to find a cure. In recent times, Professor Refshauge and her team have conducted different kinds of studies, ranging from basic science to qualitative studies, and included studies with patients leading their own care. The results are sometimes quite surprising.

Biography

Professor Kathryn Refshauge is Dean of the Faculty of Health Sciences and Professor of Physiotherapy at the University of Sydney. She is a member of several boards and committees in the health sector in NSW as well as various professional and research bodies. She has also served on the executive of the Australian Physiotherapy Association and human research ethics committees, and was involved in the Excellence in Research for Australia initiative.

Her research focuses on integrating her physiotherapy, biomedical engineering and physiology backgrounds to improve health outcomes, particularly for musculoskeletal conditions. She is currently a chief investigator on two Centres for Research Excellence - one in Neuromuscular Disorders: Transforming the management of neuromuscular disorders from compassionate assistance to targeted therapy and prevention and the other in recovery following road traffic injuries. She has published extensively in the area of musculoskeletal health, and developed guidelines and position statements for best practice in diagnosis and management of various musculoskeletal conditions.

Professor Refshauge was awarded the Medal of the Order of Australia in 2016, and is a Fellow of the Australian Academy of Health and Medical Sciences. In 2011, Professor Refshauge received the Vice-Chancellor's Award for Excellence in Research Student Supervision and a national award for Outstanding Contribution to Student Learning by the Australian Learning and Teaching Council. She holds several honorary professorial appointments and is a member of editorial board of international journals.

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