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Adolescents (and their families) in the UK and around the world are now better able to cope with chronic pain because of the unique work carried out at the University of Bath Centre for Pain Research (BCPR), directed by Professor Christopher Eccleston.
The BCPR produced the first multidimensional `one-stop' tool to assess the impact of pain on children's lives, which has now been adopted in at least 12 countries. Pioneering treatments from Bath have influenced therapeutic approaches worldwide.
The Bath team also manage the evidence base for chronic pain, giving access through the Cochrane Library, advising internationally on clinical service development and improvement.
Our research has produced a paradigm shift in the primary care management for back pain, by expanding traditional diagnostic approaches to attending to physical and psychosocial factors shown to influence future outcome (`prognosis'). We have developed screening tools (freely available, widely accessed, translated and adopted), to distinguish groups at low or high risk of long-term disability, and developed primary care interventions tailored to these groups. Through improved clinical outcomes and cost-effectiveness, we have changed back care at national and international levels, evidenced by inclusion in official guidelines, into training of health professionals, adoption by spine and pain services, and active engagement of health care commissioners, clinicians and educators.
The Pain Research Group (PRG) is a research team within the Centre for Health and Social Care Research (CHSCR). The PRG's research programme in chronic pain management encompasses a range of robust methodological approaches to achieve better patient outcomes with local, national and international impact. The PRG has adopted a dual approach to investigating the treatment of chronic pain, incorporating psychological factors with the application of neuromodulation techniques. This has led to significant improvements in patient outcomes and patient satisfaction surveys demonstrate excellent, positive results. The research has had significant influence on clinical practice at national level, underpinning recommendations for best practice issued by the British Pain Society in relation to spinal cord stimulation and intrathecal drug therapy. It has also contributed to NICE's clinical guidelines on the implementation of spinal cord stimulation and influenced clinical decision making through the NHS evidence database. At an international level, our research has contributed to three sets of guidelines issued by the Polyanalgesic Consensus Conference: inflammatory mass, intrathecal drug therapy for chronic pain and recommendations for reducing mortality and morbidity of intrathecal drug therapy. The reduction of morbidity and mortality in intrathecal drug therapy is of particular significance as the reduction of harm and unnecessary complications in healthcare is of high concern to healthcare organisations worldwide.
The Glasgow Composite Measure Pain Scale (CMPS) has provided the first validated pain questionnaire for the rapid assessment of acute pain in dogs in surgical and clinical settings. Developed by the University of Glasgow School of Veterinary Medicine, the scale aids clinical decisions on appropriate pain relief intervention and has been freely downloaded by over 3,000 clinical users since its launch in 2008. In addition, it has been used extensively by veterinary healthcare companies to successfully obtain regulatory approval for analgesic drugs and in marketing support materials. The University of Glasgow researchers have been instrumental in developing international pain guidelines with the World Small Animal Veterinary Association, which represent more than 180,000 veterinarians worldwide, and has thereby promoted awareness of pain management in companion animals.
McCluskey and Burton at the University of Huddersfield's Centre for Health and Social Care Research (CHSCR) have made significant contributions to bringing about a cultural shift in how back pain is viewed and treated. Our research has underpinned a new approach which replaces rest and reliance on healthcare with activity, positive attitudes and remaining at, or returning early to, work as the preferred responses to back pain. We have demonstrated that prompt recovery from back pain and continued work participation can best be addressed from a biopsychosocial perspective. Innovative interventions aimed at overcoming biopsychosocial obstacles have been based on evidence from our research which shows that key stakeholders, including individuals, employers, healthcare practitioners and members of the wider society, need to work together in order to support the occupational rehabilitation of people living with back pain.
Newcastle University research has changed policy and practice relating to the provision of pain relief to rodents and rabbits. This has impacted on up to 35 million animals worldwide during the REF period. Having established the under-use of analgesics in laboratory rodents, Newcastle researchers developed objective pain scoring systems. These established that analgesics should be administered to rodents and rabbits, and that the efficacy of this treatment should be assessed objectively. The research resulted in changes to policy statements, institutional policies (both academic and industrial) and individual research worker practices in the USA, Canada, Australia, Europe and the UK. This has produced clear benefits to the welfare of animals used in biomedical research, helps to satisfy public concerns that animals used in research should experience the minimum pain and distress, and improves scientific outcomes of research, since pain is an uncontrolled experimental variable, that can adversely affect study results.
Around half of older people, aged 65 and over, experience persistent pain; it can be isolating and seriously affect quality of life. This research, much of it done by service users, has produced tools and information for older people themselves, and for the professionals who work with them, to correctly assess and treat chronic pain. It is setting national standards, being adopted by the key national charities and NHS pain clinics, and garnering international interest. Specifically the work has:
Chronic pain, defined as pain lasting for more than 6 months, affects more than 25% of adults in developed nations. Drugs are costly, carry risks of side effects and dependence, and are of limited effectiveness in many cases. Morley, at the University of Leeds (UoL), collaborated on a series of definitive reviews and meta-analyses proving that active psychological treatments based on cognitive behavioural therapy (CBT) are effective in treating chronic pain. This led to changes in UK government and world health organization (WHO) guidelines and the adoption of CBT at specialist pain clinics, reducing patient suffering, increasing social role functioning and ensuring more cost-effective treatment.
More than three million people are in pain at any one time in the UK, with inadequate analgesic treatment because of side-effects or lack of drug efficacy. By identifying roles for the voltage-gated sodium channel subtypes Nav1.7 and Nav1.8 in peripheral pain, our research has had a significant impact on the clinical understanding of human pain disorders and on the commercial development of selective analgesics with fewer side-effects. We have developed and disseminated several transgenic mouse lines which are widely used by the pharmaceutical industry. Through media appearances, we have also increased public awareness of the physiological basis of pain.