Tag Archives: #PainResearch

Time of day and chronic pain – how they are connected and why we should care

A cross-Canada research team has launched the CircaPain project to learn why chronic pain might fluctuate throughout the day

Everyone feels pain differently, and most research studies have worked to understand where, why, and how it happens. However, there is little data available on when pain happens. The new CircaPain study is seeking help from Canadians living with chronic pain to better understand changes in their pain throughout the course of each day. Pain fluctuations, or lack thereof, could be related to the type of pain condition, sleep habits, or even where people live.

Regardless of pain severity, some people experience constant pain all day while others experience pain that changes throughout the day. This could mean fluctuations from day to day or fluctuations within the day. For example, some people may feel more pain in the morning than in the evening, while others have more pain in the winter than in summer.

It has been proposed that these fluctuations are linked to our 24-hour circadian rhythms (our sleep-wake cycles). These circadian rhythms influence a lot of what happens in our bodies, especially when it comes to the function of nervous tissue and immune cells. The nervous and immune systems are vital to our experience of pain, which is why understanding how these pain fluctuations occur is so important.

A team made up of researchers from Queen’s University, Kingston Health Sciences Centre, and the Université de Montréal is working together to dive a bit deeper into the relationship between the circadian system and chronic pain and find out why rhythmic pain fluctuations occur. For this project to be successful, the team needs as many people as possible to take part in the study.

The study is now recruiting participants and can be accessed at www.circaain.ca. It consists of two parts: the first is an online survey to understand study participants’ pain experience and daily habits (e.g., sleep/wake, coffee intake, etc.). Travel history and geographic location will also help the team learn whether daylight hours might play a role in pain. In the second part of the study, participants complete a 7-day electronic diary that collects data on their pain, mood, and other factors at three time points per day (8am, 2pm, and 8pm).

The CircaPain team hopes that the data collected in this study will provide individuals with a better understanding of their own pain, and in the process shed new light on how day/night changes might contribute to chronic pain. “We have the potential here to change how we think about pain, and spur the development of new personalized treatments across pain conditions,” said study lead investigator Dr. Nader Ghasemlou, an associate professor at Queen’s University.

Do you have questions about the study or want to learn more about the circadian control of chronic pain? Check out www.circapain.ca or email us at mydailypain@ghasemloulab.ca.

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Support for this research is provided by the Canadian Chronic Pain Network, part of the Canadian Institutes of Health Research-Strategy for Patient Oriented Research program.

 

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Clinical Biomechanics – interplay between pain and gait biomechanics

Join the Canadian Musculoskeletal (MSK) Rehabilitation Research Network for the GaitNET-Osteoarthritis Canada Seminar Series (Nov 30th)

Date: Tuesday, November 30, 2021  |  Time: 12:00-2:00pm (EST) via Zoom Free, but pre-registration is required. 

This exciting seminar series focuses on research priorities in gait biomechanics research. We aim to stimulate discussion among researchers, trainees and clinicians to increase collaboration, build links between biomechanics labs and discuss priorities and opportunities in the field.

Building on the successful Biomechanics & Osteoarthritis Symposium held in May, 2021 (listen to the recorded session here), this November 30th webinar focuses on clinical biomechanics research relating to pain and gait biomechanics.

Leading experts Drs. Monica Maly, Katherine Boyer, Tuhina Neogi, Lisa Carlesso, and Tim Wideman will share advances in pain science including mechanisms of pain generation and perception, as well as how altered gait biomechanics may influence pain. They will discuss key concepts to consider when conducting clinical biomechanics research that includes both pain and biomechanical outcomes.

Speaker information:

Dr. Katherine Boyer (Associate Professor, University of Massachusetts Amherst)

Dr. Boyer’s researchers lower extremity mechanics during locomotion and the mechanisms for adaptations in ambulatory mechanics in aging, with overuse injury and in response to mechanical and pharmacological interventions. She uses a stimulus-response experimental model to probe the interaction between gait mechanics, neuromuscular function, systemic biological marker and joint injury and degeneration.

Dr. Monica Maly (Associate Professor, University of Waterloo)

Dr. Maly’s research program focuses on developing biomechanically-sound physical activity guidelines for adults with the most common forms of arthritis that are associated with aging. Promoting physical activity is paramount to the well-being of Canadian adults as they age – exercise provides as much pain relief for arthritic pain as drugs, while also reducing the risk for co-morbidities including cardiovascular disease and cancer. However, excessive physical activity, due to work or recreation, can promote joint damage. Canadians with arthritis have no guidance on the amount, type or intensity of physical activity that damages joints. She uses biomechanical methods to evaluate the impact of physical activity on joint health, with an aim to develop guidelines for physical activity that promote health and productivity, while minimizing the risk for arthritis progression.

Dr. Tuhina Neogi (Professor, Boston University)

Dr. Neogi is a rheumatologist and epidemiologist who researches knee osteoarthritis and gout, pain mechanisms in knee osteoarthritis, as well as methods issues in rheumatic diseases. She has held peer-reviewed foundation and NIH funding since 2003, with >250 peer-reviewed publications.

Dr. Neogi is a past chair of the FDA Arthritis Advisory Committee, has served on the boards of two international societies: Osteoarthritis Research Society International (OARSI) and Gout, Hyperuricemia, and Crystal-Associated Diseases Network (G-CAN), and on committees for the American College of Rheumatology (ACR) and International Association for the Study Pain (IASP).

Dr. Lisa Carlesso (Assistant Professor, McMaster University)

Lisa Carlesso is a licensed physiotherapist and an assistant professor in the School of Rehabilitation Science at McMaster University. Her extensive academic background in physical therapy and clinical epidemiology have shaped her research interests in common age-related musculoskeletal problems. Dr. Carlesso’s most recent studies focus on improving treatment and outcomes for people with musculoskeletal disorders, such as knee osteoarthritis and chronic low back pain and is interested in understanding the mechanisms and consequences of pain as they relate to disability, mobility, participation and healthy aging.

Dr. Michael Hunt (Professor, University of British Columbia)

Dr. Hunt’s research interests focus on identifying changes in movement patterns and biomechanics as a result of injury or disease. The Motion Analysis and Biofeedback Laboratory uses state-of-the-art real-time motion analysis techniques to analyze movement pattern differences between injured and healthy individuals. He then uses this information to develop targeted treatment approaches that aim to optimize function and/or prevent disease progression. His primary group of interest is individuals living with osteoarthritis (OA) of the knee. He has identified key gait deviations exhibited by those with OA that have the potential to alter the loading patterns at the knee – a known risk factor for disease progression. He has also studied the role of exercise and movement retraining on biomechanical (joint loading) and clinical (pain, function) disease characteristics. Dr. Hunt works closely with experts in rheumatology, physical therapy, orthopaedic surgery, and neuroscience.

Dr. Timothy Wideman (Associate Professor, McGill University)

The overarching goal of Dr. Wideman’s research is to improve care for people living with pain. He approaches this goal by advancing research related to the following three themes: Understanding and targeting biopsychosocial risk factors for prolonged pain and disability, Improving entry-level pain education for health professionals through large-scale knowledge translation initiatives, and Developing person-centred approaches to pain assessment and management that help validate and support people living with pain.

 

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What do Canadian Pain Research Trainees Know about Patient Engagement? Partnering with people who live with pain to find out.

Authors: Therese Lane, Dawn Richards & Kyle Vader

Patient engagement (PE) in research is defined as “meaningful and active collaboration in governance, priority setting, conducting research and knowledge translation.” Despite recognition of the value of PE in pain research (e.g., funding of the CIHR-funded Strategy for Patient-Oriented Research (SPOR) Chronic Pain Network), little research has been published on the implementation of PE by certain groups, such as pain research trainees. A better understanding of current perspectives and experiences, perceived barriers/facilitators to implementation, and recommendations may help to improve how PE is done by pain research trainees.

We’re using this blog to describe our experiences as a diverse group of researchers (e.g., patient partners, trainees, and faculty members) who came together to better understand the current state of PE amongst pain research trainees in Canada. The idea for this work came about after several informal discussions between a group of trainees conducting pain research who had various degrees of exposure to PE in research. Following these discussions, we decided to conduct an online survey (in French and English) to understand more. With the support of the PE Committee of the Chronic Pain Network, we secured funds to support the operating costs of this work. In keeping with the overarching principles of PE, patient partners were involved throughout this work, from study conceptualization to survey development, survey dissemination, analysis, and knowledge sharing. To facilitate deep and rich PE, we found that from a process perspective, using a combination of meetings specifically with patient partners as well as our entire research team was helpful.

In the end, our survey consisted of 20 questions, including a combination of closed- and open-ended questions. We shared our survey through targeted emails and broadly through social media (e.g., Twitter posts). Our final analysis included 115 survey responses (105 English; 10 French). Among our respondents, 89.6% (103/115) reported that PE is ‘very’ or ‘extremely’ important. Despite this, 58.6% (65/111) reported that they ‘never’ or ‘rarely’ implement PE in research when they are the primary researcher (e.g., their thesis research).

When respondents were asked to provide recommendations for implementing PE amongst pain research trainees, they provided diverse responses. Using qualitative content analysis, we identified four key recommendations. They are to:

1) Improve availability and accessibility of training opportunities and resources on PE in research,

2) Provide more funding opportunities that support and/or require PE in research,

3) Create systems to support trainees to find patient partners, and

4) Ensure that supervisors, departments, and institutions support and encourage PE in research.

From this work, we have learned that although most pain research trainees in Canada see value in PE, many are not implementing it in their own research. Our hope is to build a community of pain research trainees and patient partners who can work together to co-design and implement patient-oriented research projects across the research continuum. We hope to create practical resources and solutions (e.g., tools, toolkits, simple guides, apps) so that pain research trainees can work collaboratively and effectively with patient partners.

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