Low back pain (LBP) is highly prevalent and enormously expensive to society: total payments made by Workcover for injuries to the low back were in excess of $530 million in NSW in 1996. Chronic LBP (pain lasting more than 3 months) accounts for up to 90% of these costs. Prevention of a large part of this costly problem could be achieved by effective treatment at the earlier sub-acute phase of LBP (6 weeks to 3 months duration). Exercise and advice are two widely-used treatments for sub-acute LBP ....Low back pain (LBP) is highly prevalent and enormously expensive to society: total payments made by Workcover for injuries to the low back were in excess of $530 million in NSW in 1996. Chronic LBP (pain lasting more than 3 months) accounts for up to 90% of these costs. Prevention of a large part of this costly problem could be achieved by effective treatment at the earlier sub-acute phase of LBP (6 weeks to 3 months duration). Exercise and advice are two widely-used treatments for sub-acute LBP, yet remarkably, their efficacy is unknown. For the first time, this study will rigorously evaluate the effectiveness of both a supervised exercise program and advice to return to normal activity for sub-acute LBP. When this study is completed, Australian practitioners will be able to adopt evidence based practice when managing sub-acute LBP. In addition, the study's results will enable practitioners to select the most effective treatment for each individual patient. The results of this study should lead to a large reduction in the incidence of chronic LBP, therefore the results should lead to significant savings in terms of social and economic costs.Read moreRead less
INVESTIGATIONS ON THE REGULATION OF INTERVERTEBRAL DISC CELL MATRIX METALLOPROTEINASES
Funder
National Health and Medical Research Council
Funding Amount
$331,320.00
Summary
Degeneration of the intervertebral disc is a painful disabling condition with major socioeconomic consequences. Medical problems associated with disc degeneration and back-pain, of sufficient severity to warrant consultation with a physician, are experienced by 90% of the population some time during their lives. In man, back pain increases in incidence in the third and fourth decades of life, peaks in the fifties and declines thereafter. Changes in population demographics indicate this problem w ....Degeneration of the intervertebral disc is a painful disabling condition with major socioeconomic consequences. Medical problems associated with disc degeneration and back-pain, of sufficient severity to warrant consultation with a physician, are experienced by 90% of the population some time during their lives. In man, back pain increases in incidence in the third and fourth decades of life, peaks in the fifties and declines thereafter. Changes in population demographics indicate this problem will increase in severity over the next few decades. American Bureau of Census data indicate that between 1990 to 2010 the number of people >45 years will increase from 82 to 124 million, the number of elderly in emerging countries will also increase between 200 to 400% in the next 30 years. In the United States, back-pain is the second most common reason that people visit a physician and medical conditions related to back-pain account for more hospitalisations than any other musculoskeletal disorder. Despite its high incidence, associated problems of incapacity and economic implications, costed at $100 million per annum in Australia in 1992, and US$100 billion globally in 1999-2000 (Dorland Data Networks, PA, USA) the causes of low back-pain are still poorly understood. Disc disease is responsible for 23-40% of all cases of low back-pain. The management of discogenic low back-pain is currently empirical, directed either toward life-style changes to minimise symptomatology or to surgical resection or spinal arthrodesis to restrict articulation. Based on our recent findings and those of colleagues over the last 16 years, it is our strong conviction that it should be possible with a better understanding of disease mechanisms and with the use of modern technologies to inhibit, reverse or ideally prevent disc degeneration. Without such basic research there will be no scientific foundation upon which prospective therapies may be based.Read moreRead less
Spinal complaints present the greatest social and economic burden of musculoskeletal conditions in Australia. This reflects current realities: the cause remains unknown; 80% of the population is affected; and isolated professions perform a staggering array of interventions. The CCRE aims to target these realities and improve Australia's capacity to prevent and manage spinal disorders by supporting innovative interdisciplinary research and training. This community- and university-based centre wil ....Spinal complaints present the greatest social and economic burden of musculoskeletal conditions in Australia. This reflects current realities: the cause remains unknown; 80% of the population is affected; and isolated professions perform a staggering array of interventions. The CCRE aims to target these realities and improve Australia's capacity to prevent and manage spinal disorders by supporting innovative interdisciplinary research and training. This community- and university-based centre will align highly successful clinical and basic researchers in collaboration with a national network of spine scientists to foster interdisciplinary clinical researcher training, develop new diagnostics and therapeutics, and translate findings to the community. Through clinical research the centre aims to: (i) Advance understanding of physiology and pathophysiology of spinal pain (ii) Translate findings from basic research to clinical practice (iii) Establish coordinated multidisciplinary research to reduce the burden of spinal pain (iv) Predict and prevent the transition from acute to chronic states (v) Train a new generation of transdisciplinary clinical scientists (vi) Rapidly assess new treatment possibilities in pre-clinical studies (vii) Develop innovative technologies for diagnostics and therapeutics (viii) Encourage Australian commercialisation opportunities for new discoveries (ix) Encourage community-user participation in direction of research programs (x) Disseminate new findings and information of evidence-based practice to patients, clinicians, insurers, government and the scientific and wider communityRead moreRead less
Pain And Trunk Muscle Control: Effects, Mechanisms And Consequences
Funder
National Health and Medical Research Council
Funding Amount
$296,452.00
Summary
Twenty-one percent of Australians report long-term back problems. This makes back pain the most common chronic pain in Australia and most prevalent disorder among the National Health Priority Areas. For the majority with recurrent and chronic problems, the cause is unknown but changes in control of the spine are thought to be important. It is well accepted that pain and injury to the low back affect the way that we control the back muscles and this leads to changes in spinal function. However, d ....Twenty-one percent of Australians report long-term back problems. This makes back pain the most common chronic pain in Australia and most prevalent disorder among the National Health Priority Areas. For the majority with recurrent and chronic problems, the cause is unknown but changes in control of the spine are thought to be important. It is well accepted that pain and injury to the low back affect the way that we control the back muscles and this leads to changes in spinal function. However, despite considerable investigation of this problem, there is a distinct lack of consensus for how the control of movement is changed during pain, why it changes, and whether these changes lead to further problems in the long term. The objective of this series of studies is to determine how the adaptation to pain changes the control of the spine. We will use a range of techniques that include tests of the strategies used by the brain to control the spine and mathematical models to estimate the effect that these changes have on the spine when people are given back pain by injecting sterile salty water into the back muscles. These studies will be backed up by measures of mechanical properties of the spine and by comparison to people with clinical pain. This combination of methods has not been used previously and is likely to help resolve the problem of how muscle control is chaged in back pain. We will also test a range of hypotheses regarding how pain has its effect on muscle activity. A final series of studies aims to determine whether the failure of these changes in muscle control to resolve after an epiosde of back pain leads to increased recurrence of pain in the long-term. The importance of this project is highlighted by the significance of back pain as a major health issue, the lack of consensus regarding the effect and mechanisms of pain on trunk muscle control (despite extensive investigation), and the potential for the findings to guide rehabilitation and management.Read moreRead less
Back pain reduces Australia�s GDP by $3.2 Billion per annum with over $1 billion being spent each year on low back pain treatments. While it makes sense to devote resources to prevention, unfortunately most prevention strategies do not work.We need a new approach based upon a better understanding of what triggers an episode of back pain. By studying risk factors that occur immediately prior to an episode of low back pain this project will increase understanding of what triggers an episode and op ....Back pain reduces Australia�s GDP by $3.2 Billion per annum with over $1 billion being spent each year on low back pain treatments. While it makes sense to devote resources to prevention, unfortunately most prevention strategies do not work.We need a new approach based upon a better understanding of what triggers an episode of back pain. By studying risk factors that occur immediately prior to an episode of low back pain this project will increase understanding of what triggers an episode and open the way for new, effective prevention programs.Read moreRead less
Development Of Potent And Selective Blockers Of Acid Sensing Ion Channels For The Treatment Of Pain
Funder
National Health and Medical Research Council
Funding Amount
$578,704.00
Summary
More than three million Australians suffer from chronic pain, and there are few effective drugs available for treating this condition. A 2007 Access Economics Report estimated the economic burden of chronic pain in Australia at $34.3 billion. Acid-sensing ion channels (ASICs) are a recently discovered family of proteins that play a key role in sensing pain. The goal of this project is to develop potent blockers of these channels that can be used to treat patients suffering from persistent pain.
Innovation In The Primary Care Management Of Back Pain
Funder
National Health and Medical Research Council
Funding Amount
$152,595.00
Summary
Back pain affect millions of Australians. Billions of dollars are spent each year on treament but health outcomes are often poor. Experience from overseas shows that simply spending more money on current treatments won’t fix the problem. This fellowship will be used to support a program of research to improve the quality and efficiency of treatments and health services.