Welcome to the eighth edition of the Churack Chair Newsletter - a newsletter which provides supporters and friends of the Churack Chair of Chronic Pain Education and Research with the latest updates on how the Chair is reducing the impact of chronic pain in our community through research and the education of medical students in the area of chronic pain management.

As always, we express our gratitude for your ongoing support, dedication and interest. We look forward to sharing ongoing updates and the Chair’s next milestones.

We thank you very much for your ongoing support and interest.

Kind regards,
Eric Visser

Churack Chair Research Focus

Significant activity has continued at the Churack Chair over the past 12 months, with a current focus on research development. However pain education still continues as a priority for medical students, healthcare professionals and persons living with pain. In the latest development, medical students at SJOG Subiaco Hospital are now assigned to pain medicine ward rounds for 'teaching-on-the-run sessions' and tutorials with Professor Visser and Mrs Jillian Kelly, our pain nurse practitioner and adjunct member of the School of Medicine.​ We are also supporting the training of a fantastic young nurse practitioner in pain medicine at SJOG which is great for the future of the hospital.

Doctor of Philosophy (PhD) research

Our two PhD candidates Mrs Elspeth Shipton and Adjunct Prof. Andrew Jan are finalising their thesis presentations.

Elspeth Shipton's five years of research has confirmed that pain education in medical schools around the world is highly variable in delivery and has a low profile in the curriculum, with an average of only 20 hours being dedicated to pain education during a whole medical course. She has developed curriculum and assessment tools that medical schools can use in the future to improve pain teaching and learning for medical students.

Andrew Jan has found evidence that acupuncture, and in particular ear acupuncture, can play an effective role in managing acute pain in the emergency department (ED), and could prove useful in reducing opioid drug side effects, including possible substance abuse. Andrew has developed new acupuncture research techniques and assessment tools and a cutting-edge acupuncture teaching programme for practitioners wishing to learn the technique. Based on Andrew's research, ear acupuncture may very well be adopted in the next few years to better manage acute pain, not only in the ED but also on ambulance services and following surgery.

New Masters research candidates

We have just enrolled a high-quality Masters candidate who will research the role of pain medications for the treatment of chronic pain in children and teenagers, which is a very under-represented area of pain research. We also have expressions of interest from two other candidates for Masters studies in pain research.

Collaborative research with other groups

We have started exciting collaborative research with A/Prof Diane Arnold-Reed, Dr Lucy Gilkes and A/Prof Caroline Bulsara in the medical school to explore the vital role of general practitioners in the assessment and management of patients with chronic pain in primary care. One interesting aspect is exploring the role of ''gut feeling'' or clinical instinct in assessing patients with pain. We hope to attract a high-quality Masters candidate who will drive this study if we are successful in an upcoming grant application to fund the research.

Centre for Research on Chronic Pain and Inflammatory Diseases, School of Psychology and Exercise Science, Murdoch University

The keystone of our research agenda is the cooperative programme with Murdoch University's Professor Peter Drummond and Dr Natalie Morellini, who is our post-doctoral Fellow in basic pain sciences research.

Covid related funding restrictions

Unfortunately due to Covid restrictions, research grants that fund Dr Morellini's Fellowship have been delayed for at least 18 months. Thankfully we received vital interim support for the next six months via a UNDA School of Medicine special research grant and other University funding, for which we are very grateful. Any donation to continue Dr Natalie Morellini's vital role in pain research via the Churack Chair would be most welcome in the wake of these Covid funding restrictions.

Please contact Mrs Shelley Mason, Fundraising Project and Donor Relations Manager, on 0409 380 881 or via shelley.mason1@nd.edu.au if you would like to learn more.

New high profile research centre cooperation

We have also recently started collaborative research projects with two high-profile researchers:

Prof James McAuley at Neuro Research Australia.

• CRPS & memantine study (March 2020).
• Low back pain & zopiclone study (February 2020).

We are included with Neuro Research Australia team as co-applicants for two NHMRC grants.​

Prof John Mamo, Curtin University.

• A new theory of migraine and a blood vessel drug migraine prevention trial, also PhD candidate supervision (March 2020).

The new UNDA online migraine research diary we developed as part of our MIGRANT study will be used to collect patient data in this project and has gained interest from other headache and migraine researchers.

Recent research grants & funding associated with the Churack Chair

1. MRFF rare diseases programme grant, 2019, Prof James McAuley, NB Prof Visser is an associated investigator not a primary applicant; circa $1 000 000.00 AUD.
2. John Boyd Craig Prize ANZCA Research Award, Australian and New Zealand College of Anaesthetists, 2018: $45 498.00 AUD.
3. Spinnaker Foundation Research Grant, 2019: $15 000.00 AUD.
4. Inaugural Elaine Lillian Kluver ANZCA Research Award, Australian and New Zealand College of Anaesthetists, 2017: $ 99 788.00 AUD.

The MIGRANT migraine study: the result are finally in!

Our landmark MIGRANT migraine research study was published recently and was listed in the Editor's choice top 20 articles of the Pain Research Forum in April 2020. Our study has for the first time in the world literature, identified that a mixture of vitamin-based antioxidants (Vitamin C, Vitamin E and N-acetylcysteine) taken for three months, significantly reduced headaches and migraines. However a larger trial is needed to confirm the study's findings before it can be used in routine medical care.

• Research papers

  Churack Chair-associated research & publications (including Centre for Research on Chronic Pain and Inflammatory Diseases, Murdoch University).

  Visser EJ, Mitchell T.  A case of chronic pain after hip replacement surgery. Pain Management Today, 2015; 2(1): 30-33.

  Visser EJ, Ramachenderan J, Davies SD, Parsons R. Chronic Widespread Pain Drawn on a Body Diagram is a Screening Tool for Increased Pain Sensitization, Psycho-Social Load and Utilization of Pain Management Strategies. Pain Prac 2015; doi: 10.1111/papr.12263.

  Jan AL, Aldridge ES, Rogers IR, Visser EJ, Bulsara MK, Niemtzow RC. Does acupuncture have a role in providing analgesia in the emergency setting? A systematic review and meta‐analysis. Emergency Medicine Australasia. 2017 Oct 1.

  Visser EJ. Fibromyalgia syndrome: ‘A dose of the flu that lasts forever.’ Pain Management Today 2017; 4(2): 24-26.

  Jan AL, Aldridge ES, Rogers IR, Visser EJ, Bulsara MK, Niemtzow RC. Does Ear Acupuncture Have a Role for Pain Relief in the Emergency Setting? A Systematic Review and Meta-Analysis. Medical acupuncture 2017 Oct 1;29(5):276-89.

  Visser EJ, Kelly J. Discharge opioid analgesia trial following surgery: The 'one-four-the-road rule'. Medicus 2017 Apr;57(3):37.

  Jan AL, Rogers I, Visser EJ. Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non-inferiority trial. The Medical journal of Australia 2018 Mar 5;208(4):188-9.

  Shipton EE, Steketee C, Bate F, Visser EJ. Exploring assessment of medical students' competencies in pain medicine-A review. Pain Rep. 2018 Dec 12;4(1):e704.

  Shipton EE, Bate F, Garrick R, Steketee C, Shipton EA, Visser EJ. Systematic Review of Pain Medicine Content, Teaching, and Assessment in Medical School Curricula Internationally. Pain Ther. 2018; 7(2):139–161 Jul 30 (11 Citations)

  Shipton EE, Bate F, Garrick R, Steketee C, Visser EJ. Pain medicine content, teaching and assessment in medical school curricula in Australia and New Zealand. BMC Med Educ. 2018;18(1):110 (4 Citations)

  Shipton EE, Bate F, Garrick R, Steketee C, Visser EJ.  Pain medicine education in Australia and New Zealand. 2018 Australian Pain Society 38th and New Zealand Pain Society Conjoint Annual Scientific Meeting, Sydney, Australia. 8 - 11 April 2018.

  Shipton EE, Steketee C, Bate F, Visser EJ. Pain medicine knowledge of final year medical students in Australia and New Zealand. 2020 Australian Pain Society 40th Annual Scientific Meeting. Hobart, Australia. 5-8 April 2020. (unable to proceed due to Covid-19 restrictions)

  Shipton EE, Bate F, Garrick R, Steketee C, Shipton EA, Visser EJ. Systematic Review of Pain Medicine Content, Teaching, and Assessment in Medical School Curricula Internationally. IASP World Congress on Pain, Boston, USA. September 12 – 16th 2018

  Shipton EE, Steketee C, Bate F, Visser EJ. Assessment of medical students' competencies in pain medicine - a focused review. 2019 Australian & New Zealand Association for Health Professional Educators (ANZAHPE) Conference. Canberra, Australia. 1-4 July 2019

  Shipton EE, Steketee C, Bate F, Visser EJ.  A focused review of assessment of medical students’ pain medicine competencies. 2020 New Zealand Pain Society Conference, Bay of Islands, New Zealand, 19-21 March 2020. (unable to proceed due to Covid-19 restrictions)

  Visser EJ and Faculty of Pain Medicine, Australian and New Zealand College of Anaesthetists. Pain-Orientated Sensory Testing (‘POST’) Guidelines (2018). Melbourne: ANZCA; 2018. Available from:  http://www.fpm.anzca.edu.au/resources/educational-documents/documents/fpmpost-professional-document-ed02-p3.pdf

  Jan AL, Aldridge ES, Rogers IR, Visser EJ, Bulsara MK, Hince DA. Patient attitudes towards analgesia and their openness to non-pharmacological methods such as acupuncture in the emergency department. Emerg Med Australas. 2018. doi: 10.1111/1742-6723.13218.

  Jan AL, Rogers I, Visser EJ. Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non-inferiority trial. Med J Aust. 2018; 208(4):188-189.

  Visser EJ, Zollner JL. A practical checklist for managing: chronic neck pain. Pain Management Today 2018; 5(2): 66-70.

  Wheeler L, Visser EJ, et al. A GP guide to low back pain management procedures. Australian Doctor 2019 (July 19) https://www.ausdoc.com.au/therapy-update/gp-guide-low-back-pain-management-procedures

  Drummond PD, Morellini N, Visser E, Finch PM. Parallels between lumbosacral radiculopathy and complex regional pain syndrome: α1-adrenoceptor upregulation, reduced dermal nerve fibre density and hemi-sensory disturbances in post-surgical sciatica. Pain. 2019 Apr 2. doi: 10.1097/j.pain.0000000000001574. [Epub ahead of print]

  Drummond PD, Morellini N, Visser E, Finch PM. Expression of cutaneous beta-2 adrenoceptors is similar in patients with complex regional pain syndrome and pain-free controls. Pain Med 2019 pii: pnz110. doi: 10.1093/pm/pnz110.

  Drummond PD, Morellini N, Finch PM, Birklein F, Knudsen LF. Complex regional pain syndrome: intradermal injection of phenylephrine evokes pain and hyperalgesia in a subgroup of patients with upregulated α1-adrenoceptors on dermal nerves. Pain 2018; 159(11):2296-305.

  Morellini N, Finch PM, Goebel A, Drummond PD. Dermal nerve fibre and mast cell density, and proximity of mast cells to nerve fibres in the skin of patients with complex regional pain syndrome. Pain 2018. 1; 159(10):2021-9.

  Morellini N, Phillips JK, Vander Wall R, Drummond PD. Expression of the noradrenaline transporter in the peripheral nervous system. Journal of Chemical Neuroanatomy. 2019 Dec 28:101742.

  Visser EJ, Drummond PD, Lee‐Visser JL. Reduction in Migraine and Headache Frequency and Intensity With Combined Antioxidant Prophylaxis (N‐acetylcysteine, Vitamin E, and Vitamin C): A Randomized Sham‐Controlled Pilot Study. Pain Practice. 2020 Apr 19.

  Jan AJ, et al. Battlefield Acupuncture added no benefit as an adjunct analgesic in ED for abdominal, low back or limb trauma pain. Submitted in Emergency Medicine Australasia (2020) awaiting review.

  Jan AJ. Lessons learned in teaching Battlefield (ear) Acupuncture to emergency medicine clinicians. Medical Acupuncture (2020) accepted for publication.

Support the Churack Chair – Make a Gift

Your contribution will not only better aid and equip future medical graduates in the area of specialised chronic pain treatment and care, it will shape the direction of chronic pain research and rehabilitation across Australia and throughout the world. Please join with us in raising funds to ensure this project can reach its potential and not only bring a quality of life back to chronic pain sufferers but also a healing knowledge to Australian doctors and health care professionals.