This month, the 2019 Australian Pain Society 39th Annual Scientific Meeting will be held on the Gold Coast. Two physiotherapists, who will be presenting at the conference, expand on what attendees can expect from their individual sessions.

Jenni Johnson is a physiotherapist who, for the last 15 years, has been involved with implementing models of care with the NSW Agency for Clinical Innovation (ACI). The ACI created the pain management network in 2010, and since that time, Jenni has been working to implement the NSW pain plan and improve access to evidence-based pain management service delivery.

Jenni’s talk focuses on pain in the most vulnerable populations. Her keynote presentation, ‘Pain management: a wicked problem for vulnerable populations’, will focus on evidence-based approaches to pain management and how this is executed in vulnerable communities. Jenni will discuss the importance of identifying the cultural, environmental and social context of pain and how ACI has come to understand these factors in some communities. ‘We have moved pain management strategies into the community by training healthcare professionals including physiotherapists to run pain management programs that are based on the evidence. We have also trained multicultural workers and Aboriginal and Torres Strait Islander healthcare workers to understand and manage pain amongst their community members,’ Jenni says.

Attendees of Jenni’s keynote presentation will gain an understanding of the importance of pain management as a speciality in the wider community. ‘Vulnerable populations need their pain management services to be delivered in the community by the healthcare workers situated in that community, as they are the experts in this domain … and that might be, for example, a physiotherapist working in the area, but it might also be a non-clinical health worker supported with knowledge and skills by a multidisciplinary pain team to deliver the services.’

On day two of the pain conference, Jenni will also be a part of a workshop discussing the development and implementation of a national pain strategy. ‘My role is to talk about how we have actually executed a pain strategy at the state level,’ she says.

Working for a number of years with trauma patients, including brain and spinal cord injuries (SCI), sparked Jenni’s interest in pain management. ‘My interest lies in the lifelong journey of people who have a disability following major trauma, particularly how people access specialist support like physiotherapy and allied health services,’ she says. ‘That is where I started, and then I worked for NSW Health to set up the State Spinal Cord Injury Outreach Service—a statewide service for people with SCI. There are now a range of allied health staff who work across the state utilising various technologies to provide specialist support to people with SCI.’

Jenni Johnson has been involved with implementing models of care with the NSW Agency for Clinical Innovation and establishing the pain network in 2010. Jenni has been working to improve access to evidence based pain management service delivery.

APA member Julia Hush, will lead a presentation on low back pain, which, according to the Global Burden of Disease Study 2016, is the leading cause of disability in Australia and around the world. Julia is a professor of physiotherapy at Macquarie University, where she teaches clinical pain science, management of musculoskeletal pain and evidence- based healthcare in the Doctor of Physiotherapy and Doctor of Medicine programs. Julia has also led the integration of the International Association for the Study of Pain pain curriculum into the Doctor of Physiotherapy program. Her current research program includes clinical pain neuroscience, paediatric pain, personalised pain treatment for low back pain, neuropathic pain and exercise-induced analgesia.

At the conference, Julia will discuss what a paradigm shift would look like in how we understand and manage low back pain. To achieve this, Julia will consider how therapists can better understand low back pain as a complex, multidimensional and individual experience, and whether the design of new models of care for low back pain can be transformed so that care is more person-centred and individualised.

‘The utility of complex intervention development to develop new models of care for low back pain will be discussed, including the application of scholarly methodologies, such as intervention mapping,’ Julia says. ‘The importance of co-design of new models of care with multiple stakeholders including clinicians, patients and researchers will be described. Application of the quadruple aim of healthcare to optimise low back pain care will also be outlined. Finally, I will consider alternative research designs to evaluate the effectiveness of person-centred interventions.’

This session will strengthen participants’ knowledge about low back pain by learning about the significant challenges and limitations of the current paradigm of how low back pain is managed and researched in primary care. Julia says ‘a new paradigm needs to be based on an understanding of back pain as a complex, individual experience, whereby new models of person-centred care require complex intervention development with co-design from relevant stakeholders.’

Julia hopes that participants will learn about some exciting innovations in clinical low back pain research that may transform the current paradigm of management and lead to better patient outcomes.

Julia outlines that researchers, clinicians, consumers and policy-makers who have an interest in the management of low back pain and other musculoskeletal conditions may benefit from attending.

Julia Hush, APAM, is an Associate Professor of Physiotherapy in the Department of Health Professions at Macquarie University, where she is also Department Director of Research.