The pain revolution is coming
For more than 25 years Lorimer Moseley has been investigating pain in humans. His long and distinguished career has him frequently travelling the world educating the medical field and consulting government and industry bodies on pain sciences.
On the eve of the launch of his national Pain Revolution Rural Outreach Tour, Lorimer will be the keynote speaker at Tasmania’s 2019 Annual Symposium, with the topic: Movers and Shakers: Physiotherapy and the Pain Revolution.
The session will encourage physiotherapists and allied health professionals to rethink the way pain is approached in treating patients and, in turn, how patients understand pain.
As Professor of Clinical Neurosciences and Foundation Chair in Physiotherapy at the University of South Australia (UniSA), Lorimer’s work focuses on combining innovative research and evidence-based clinical practice in the treatment of pain. Coupled with his work with the Body in Mind Research Group, also based at UniSA, and the Pain Revolution, he investigates the role of the brain and mind in chronic pain to empower people with the skills and resources to prevent, recover from and find the best methods to prevent persisting pain.
‘The pain revolution is about taking the science of pain to people—we want to educate people before they need to come to the clinic needing help,’ says Lorimer of the clinical challenge of treating persisting pain.
‘In this keynote session, I will focus on how the immune and nervous systems work together to protect us from a range of threats and … present ideas on the challenge of thinking through the biopsychosocial way with therapy practice. There are some exciting developments in our understanding of how these two systems collaborate to protect us in a way that affects both movement and pain, so I will outline some of the complexities that have arisen with the increasing endorsement of the biopsychosocial model of health and the common barriers to implementing biopsychosocial care, which puts physiotherapy at an interesting crossroad.
‘We are at the beating edge of modern pain revolution and the expectations on us from the general public are changing and will require us to answer new questions. The obvious new questions we will need to answer are: how do you know when someone’s pain system is being over-protective, what can we do to retain an over-protective pain system and how can we use our trained skillset and techniques to do that, how can we do it better and how do you integrate high-value care for these patients in a financially viable way and in a way that preserves your wellbeing, as well as providing that to the patient?‘
Exploring pain has been at the forefront of the APA Honoured Member’s career. After working as a physiotherapist for seven years, he combined clinical work with research—a PhD at the University of Sydney Pain Management Research Institute and research positions at the University of Queensland, University of Sydney and Oxford University, UK.
His three decades of helping patients manage the chronic epidemic has led to some incredible statistics as health professionals strive to understand its science. He has delivered presentations in more than 30 countries (to more than 50,000 medical and health practitioners), written 320 papers, five books (including the popular Explain Pain and Explain Pain Supercharge with fellow APA Honoured Member Dr David Butler) and numerous book chapters on chronic pain and rehabilitation.
His articles on ResearchGate have been downloaded 100,000 times, placing him in the top 0.05% of all scientists internationally.
His acknowledgement by peers and governing bodies include being awarded the inaugural Ulf Lindblom Award for the outstanding mid-career clinical scientist working in a pain-related field by the International Association for the Study of Pain, and the 2013 Marshall & Warren Award from the NHMRC, for the Best Innovative and Potentially Transformative Project. In 2011, Lorimer was made Fellow of the Australian College of Physiotherapists, by original contribution, and three years later became an APA Honoured Member, our highest accolade. Last year he was awarded a Doctor of Science for his contribution to the field, and made Honorary Fellow of the Faculty of Pain Medicine, Australia New Zealand College of Anaesthetists.
He is a NHMRC Principal Research Fellow and a Senior Principal Research Fellow at Neuroscience Research Australia.
Increasing knowledge of pain science and applying new ways of understanding recovery and treatment to clinical practice will also be explored in Lorimer’s intensive one-day session on Critical Updates in Contemporary Pain Science. ‘It’s an intensive explain pain supercharged,’ says Lorimer, that will include current perspectives on how potentially dangerous events are detected, and a contemporary model of how the brain integrates sensory and stored data to keep us safe. ‘Plus, there will be some new ideas for integrating contemporary pain education into everyday treatments,’ he says.
Helping ease the suffering of others through clinical and research work, and ultimately through widespread public education, is what Lorimer is most proud of. Next year will be the third year of his Pain Revolution tour, which involves a team of health professionals cycling through regional and rural Australia to highlight the necessity and importance of all Australians having access to resources and support within their local communities to prevent and overcome persistent pain.
‘My parents told me I had always been interested in humans from a very early age. I am a curious person … and as a clinician it was the people with persistent pain who were the disadvantaged in my cohort; they were untrusted, they were misunderstood and not taken seriously and were on a descending spiral of social, behavioural and economic disadvantage. It was horrible,’ he says.
‘I think the one thing that drove me in this direction [research] was that observation and the feeling that I could not help these people, and how was I going to do it. I am still frustrated, and I really don’t understand how pain happens and how consciousness happens … but I am excited about learning that, and I guess the other side of another journey was that I had experience on the other side of the fence as a patient, so I can understand what it means to people to be consumed by pain.’
He says this understanding of pain going beyond a physical sensation to potentially affecting emotional and mental wellbeing is a real factor in why physiotherapists need to stay at the forefront of understanding its science.
‘There is a lot of people with this problem—20 per cent of Australians live with persistent pain and less than 10 per cent get the help they need to recover—it’s our biggest problem in health and costs western societies about as much as cancer and diabetes combined … Physiotherapists are justifiably the first line of care and we are also in a situation where we are in a state of rapid re-pitching of what we are, because we are learning more and more of what we do and what’s effective, what’s not and how the effective things may work for pain and movement.’
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