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Airing Pain 144: Dilemmas in Pain Research 

This episode of Airing Pain focuses on the challenges that researchers must overcome when researching pain and developing new treatment approaches. Many questions remain unanswered in the field of pain research. For example, we might know that a treatment works for some people living with pain, but we might not know how it works or why some people benefit and some do not. 


So, there is a lot of research being done to try to better understand pain. This leads to another problem: how to cope with the amount of new information emerging from research and trials? It is important that new research data is made more accessible for clinicians, healthcare workers, patients, and researchers. Data is no use unless it can be assessed and summarized so that doctors can understand how to use it to benefit their patients. 


Our contributors for this edition are leaders in this field and they discuss some of the issues they have encountered whilst conducting their research into pain and how to treat it. 


The interviews were recorded at the British Pain Society’s Annual Scientific Meeting, 2023. 




Contributors: 
Professor Robert Brownstone, Brain Research UK Chair of Neurosurgery, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology. 



Dr Neil O'Connell, Reader in Physiotherapy, Brunel University, Chair of the International Association for the Study of Pain (IASP) Methods, Evidence Synthesis and Implementation Special Interest Group. He is an advisor to Pain Concern. 



Dr Kirsty Bannister, Neuroscientist and Associate Professor at King’s College London. 



Time Stamps: 
1:22 Paul introduces Professor Robert Brownstone, Brain Research UK Chair of Neurosurgery at University College London. 


1:32 Prof. Brownstone explains what a spinal cord stimulator is, the lack of progress made with this form of treatment, the varied results the treatment gets, and why some people experience long-term pain following back surgery. 


7:40 Paul talks about Cochrane, a global independent network of health practitioners, researchers, and patient advocates who review research findings to provide a more precise estimate of the effects of a treatment. 


7:54 Paul introduces Dr Neil O’Connell, a Reader at Brunel University who was the Co-ordinating editor of the Cochrane Pain, Palliative and Supportive Care (PaPaS) group. 


8:35 Dr O’Connell discusses how Cochrane reviews research and clinical trials, and the complexities involved in gathering and interpreting evidence when developing interventions. 


17:04 Paul introduces Dr Kirsty Bannister, a neuroscientist and Associate Professor at King’s College London who specialises in neuropharmacology and runs a research group that uses animals to examine the mechanisms of pain processing. 


17:22 Dr Bannister talks about why animal models are useful for researching the responses people may have to different pain processes and researching chronic pain by measuring neuronal responses to pain. 


21:44 Paul and Dr Bannister discuss the limitations of using animals to research chronic pain. 


23:48 Paul and Dr Bannister explore why looking at a patient's experience of pain first can better inform lab research on animal models for understanding and researching pain. 


30:03 Prof. Brownstone gives some advice for those considering a spinal cord stimulator as an intervention they want to try. 




Additional Resources: 
Cochrane 

Pain Matters 73: Neuropathic pain issue 

Pain Matters 79: Navigating pathways to live well with pain 

Pain Matters 80: What treatment really works 

Neuropathic Pain 





If you have any feedback about Airing Pain, you can leave us a review via our Airing Pain survey  

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Coming 12 June: This edition of Airing Pain focuses on the dilemmas and roadblocks that researchers encounter when researching pain and developing interventions, how they may overcome them, and why systematic reviews of research are so important.

Our contributors for this edition are leaders in this field and they discuss some of the issues they have encountered whilst conducting their research into pain and how to treat it. 

Interviews in this edition were recorded at the British Pain Society Annual Scientific Meeting.

Contributors:

Professor Robert Brownstone is a Professor and Head of Neurosurgery at University College London.

Dr Neil O’Connell is a Reader in the Physiotherapy Division of the Department of Health Sciences at Brunel University London. He is also a member of Cochrane's central editorial board. 

Dr Kirsty Bannister is an Associate Professor of Neuroscience/Neuropharmacology at King’s College London.

This edition of Airing Pain focuses on the treatment of pain, the importance of catering treatment to a person’s individual genetic makeup, and why addressing the psychological dimensions of pain is crucial in treating it effectively. 

The process of finding a medication or treatment that works for a person often involves a lot of trial and error, which can be a frustrating process for someone to go through. This process can be side-stepped through the use of personalised medicine, where information about a person’s genetic makeup is used to tailor and optimise their treatment so it is as effective as possible.

Although medication is oftentimes a vital part of treating pain, incorporating psychological treatment alongside medication can be hugely beneficial when it comes to making pain management better for those living with acute or chronic pain. Changing how someone thinks about pain can enhance their response to the physical components of the treatment they receive.

Our contributors for this edition discuss the ways in which the treatment of pain can be made more effective for people by incorporating personalised medicine or psychological treatments into a person’s care plan. Please leave us a review on this platform or give feedback via our Airing Pain survey.

Contributors:
Professor Tony Dickenson, Professor of Neuropharmacology at University College London.

Dr. Beth Darnall, PhD, Professor of Anesthesiology, Perioperative and Pain Medicine at Stanford University School of Medicine. Director, Stanford Pain Relief Innovations Lab.

Professor Irene Tracey, Vice Chancellor of the University of Oxford and a Professor of Anaesthetic Neuroscience in the Nuffield Department of Clinical Neurosciences.

Read transcript

Thanks:
This edition of was made possible thanks to funding from the Guy Fawkes Charitable Trust and support from the British Pain Society.

Time Stamps:
1:11 Paul introduces Professor Tony Dickenson,who he spoke to at the British Pain Society Annual Scientific Meeting 2022.

3:21 Professor Tony Dickenson discusses ‘precision medicine’, ‘personalised medicine’, and how looking at peoples' genetic makeup can help medical professionals treat pain more effectively. 

14:21 Paul introduces Dr Beth Darnall, who he spoke to at the British Pain Society Annual Scientific Meeting 2023.

14:54 Dr Beth Darnall explains the psychological components of how people experience pain.

20:24 Paul introduces Professor Irene Tracy, who he spoke to at the British Pain Society Annual Scientific Meeting 2023. 

20:57 Dr Irene Tracy discusses the work she's done on neuroimaging and how the human brain constructs the experience of pain. 

23:22 Paul and Dr Tracy talk about what neuroimaging tells us about the multidimensional way the human brain reacts to pain.

26:06 Beginning of discussion about Empowered Relief, a psychology-based intervention that provides people with skills and tools to help manage their acute or chronic pain. 

26:31 Dr Beth Darnall discusses the psychological side of treating pain and how empowered relief is used to help people manage their pain.

29:10 Dr Beth Darnall talks about the psychological tools people learn through Empowered Relief and how they help with pain management.   

Additional Resources:
Airing Pain 100: Glasgow Pain Education Sessions
Empowered Relief 
Pain Matters 80: What treatment really works 

Coming 10 April: This edition of Airing Pain focuses on the treatment of pain, the importance of catering treatment to a person’s individual genetic makeup, and why addressing the psychological dimensions of pain is crucial in treating it effectively.  

Our contributors for this edition discuss the ways in which the treatment of pain can be made more effective for people by incorporating personalised medicine or psychological treatments into a person’s care plan. 

This edition will be funded by the Guy Fawkes Charitable Trust and was created with support from the British Pain Society.

Contributors: 

Professor Tony Dickenson, Professor of Neuropharmacology at University College London 


Dr. Beth Darnall, PhD, Professor of Anesthesiology, Perioperative and Pain Medicine at Stanford University School of Medicine. Director, Stanford Pain Relief Innovations Lab.


Professor Irene Tracey, Vice Chancellor of the University of Oxford and a Professor of Anaesthetic Neuroscience in the Nuffield Department of Clinical Neurosciences. 

In this edition of Airing Pain, Paul investigates the significant inequalities and disparities in treatment among primary care pain management services.

This edition of Airing Pain sheds light on the unique challenges of living with cancer as a child or young adult, and the later impacts of the cancer treatment they underwent during the critical formative years. Airing Pain speaks to experts on the longitudinal impacts of cancer for these age groups; across medical, physical, and psychosocial.  

Pain and fatigue are commonly reported as the most significant negative impact on quality of life when living with cancer. Until quite recently there has been little research in the area of living with cancer and experiencing medical treatments for cancer as a child or young adult during the critical formative years, and even less so on the long-term impacts these treatments can have throughout later adulthood.  

Our contributors discuss a variety of determinants that impact long-term effects such as type of treatment, type of cancer, their personal resilience, and their family and social support networks. We also hear of the opportunities in improving cancer care for these age groups, particularly with the difficult transition from child to adult care units. 

Contributors: 

- Emeritus Professor Sam Ahmedzai, NIHR National Specialty Lead for Cancer 

- Professor Diana Greenfield, Senior Consultant Nurse at Sheffield Teaching Hospitals Trust 

- Ceinwen Giles, Co-CEO, Shine Cancer Support 

Time Stamps: 

0:50 Paul introducing Emeritus Professor Sam Ahmedzai, an internationally recognised pioneer in setting up palliative medicine. 2022 British Pain Society interview.

2:53 Discussion around later hormonal effects of some successful treatments used to eradicate and manage cancer in children and teenagers.

5:54 Professor Diana Greenfield, Senior Consultant Nurse at Sheffield Teaching Hospitals Trust, NHS, on the transition between paediatric to adult cancer care.

13:18 The importance of family-centred care. Defined as a house or unit of care that can be traditional or non-traditional but represents a holistic support network.

18:00 Ceinwen Giles, Co-CEO, Shine Cancer Support, working to provide support for people in their 20s 30s and 40s who have lived with cancer and chronic cancer.

19:00 Ceinwin Giles talking on her personal experience of receiving treatment for non-Hodgkin lymphoma and challenges in finding peers her own age who share her experiences.

21:54 Managing early-life considerations alongside cancer. Career uncertainty, mental health in jobs, as well as fertility, relationships, and dating.

23:00 The difficult transition from child to adult care, in terms of having fewer people and services supporting as an adult. There are opportunities to improve the easing of this transition, especially following the pandemic where services are stretched.

25:20 Invitation to respond to the Airing Pain survey.

26:02 Summary of the key take home messages for children and young adults, and those caring for them.

Additional Resources: 





 Airing Pain 140: Childhood Pain - Adverse Experiences and Parental Relationships

Shine Cancer Support
Families and Children Resource Page 

Airing Pain 118: Pain Management in Young People