Dilemmas in Pain Research

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 

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