IASP 2024 Pain Conference

Overview

The decision to attend the IASP Pain Conference was easy as it was in Amsterdam, the country I spent 14 years of my life, where I haven’t been back to in 7 years! Perfect time.

What was I hoping to get out of it? More knowledge on pain and how I can use this knowledge to improve the care of my patients, Adapt Movement and Geraldton (and surroundings) as a whole.

Overall it was an incredible experience hearing some amazing speakers, researchers and clinicians talk about their efforts in their research and how they aim to improve the care for patients living with pain. Unfortunately, there was only one of me and often there were 5-6 sessions running concurrently which meant I did not get to hear everything (actually only a very small portion).

My impression:

Pain is a condition where psychology and physiology are interconnected and influenced strongly by social factors.

• This was not something new but confirmed by the varied topics and speakers in all areas. The area of pain is truly a space where biological, psychological and social aspects closely interact making it such a complex phenomenon. Workshops, lectures, etc. covered all three aspects with a larger focus on psychological and biomedical factors vs social factors. Which continues to be an under-researched area that will likely give us so much further insight.

Progress is being made in improving pain care.

• There truly is a large push from people to bring better pain care to all parts of the world. I attended a great thought provoking workshop facilitated by Mulugeta Chala, Anupa Pathak, Adrian Traeger and Michiel Reneman on barriers and facilitators to delivering high-value care. While Helen Slater (Australia and WA’s own) outlined her and others efforts to bring high value care to different parts of the world on a larger scale.

The Australian system may not be that bad after all.

• I often complain about the constraints we have in Australia to be able to provide high value care to our patients, from lack of funding to a system that promotes/incentivises quantity over quality and low value care over high value care. However, hearing from others, especially low-middle income countries highlighted that our system is not so bad after all.

There is still a large gap between research and clinical application, and it is best to use a wait

and see approach as clinicians prior to implementing new research/treatments until it truly is

convincing.

• New is always exciting! New, fancy, shiny machines always capture our attention as healthcare professionals. Is this the method, treatment, intervention which is going to solve the patients problems? We have an amazing history of using new treatments that later end up having very little use or even harm, e.g., ultrasound therapy, opioid epidemic, etc. Listening to the details of how these studies are conducted, underscores how these are often not applicable to real life, firstly they are often studies on animals, in controlled environments, have large exclusion criteria, etc. Even listening to Peter O’Sullivan speak about Cognitive Functional Therapy and its amazing results, I couldn’t help but think how this is still quite far from applicable to real life. The physiotherapist in the study received 80hr of training and mentorship (not available to the public).

There is still a large effort to find structural causes to explain persistent pain.

• Numerous speakers highlighted the shortcoming on the biomedical model in treating/managing persistent pain, and I think the research overwhelmingly supports this. However, there were also speakers that still dedicated their research on trying to find structural causes for persistent pain (including fascia and fibrosis). Although their research was fascinating. The only question on my mind was, will this ever be useful for actual patients, and I am not so sure of this.

Highlights:

Discussion around central sensitisation

• Specifically, a discussion/presentation facilitated by Emanuel van den Broeke, Per Hansson and Kirsty Bannister was truly fascinating, thought-provoking and surprisingly very entertaining! I had believed that central sensitization (and peripheral sensitization) was a really useful concept in understanding persistent pain and I have read most papers by Jo Nijs and Clifford Woolf. However, these presenters quite compellingly questioned the meaning of central sensitisation and its use in clinical practice.

Romy Parker

• Over the course of the 5 day conference, the majority of workshops and lectures were presented by researchers which obviously can get quite technical in terms of methodology of their studies, statistics etc. Although truly fascinating and hugely important, as a healthcare professional you still continuously think how can I apply this to my practice, what is relevant, what isn’t (yet). You can also lose sight of the person's individual lived experience of pain (vs. numbers/data). This is where Robbie Parker came in, a physio based in South Africa. Robbie has done some fascinating research in phantom limb pain, post-amputation rehabilitation. However, the most gripping part of her presentation was highlighting and sharing the patients experiences and stories. Beside being a great end to the conference it also reminded me what I do it for and why I love what I do.

This blog was written by Samuel Bulten