Media Stories 2012

Illusions could be key to pain management

29 November, 2012 Tasha Stanton

Pain relief for thousands of Australians could one day be attained through nothing more than some video trickery.

Speaking at a medical research conference on the Gold Coast, Adelaide-based Tasha Stanton has told delegates about her work on how illusions can be used to relieve chronic pain.

Using a device known as Mirage, doctors can manipulate real-time video images of a patient’s pain-affected area and, in combination with other sensory tools, trick the brain.

The device’s near-miraculous properties were discovered by accident when the University of Nottingham in England allowed people to try out the illusion during an open day in 2010.

Several of those with arthritis who used the device reported a significant reduction in pain, suggesting a more practical application for the technology than originally intended.

Dr Stanton told AAP using Mirage to appear to stretch the hand of a patient with osteoarthritis, combined with tactile inputs, had reduced pain levels by half, almost instantly.

She said while the research was still in its early stages, the preliminary findings strongly suggested a link between visual inputs and how the brain handles chronic pain.

“Even though we’re not actually doing anything with the painful body part at all, we’re influencing pain and we think this is targeting the brain,” Dr Stanton said.

“This is really incredible because for a lot of these conditions we’re not able to touch them with certain medications or other various strategies.”

Dr Stanton said researchers were now trying to work out just how the treatment works, with other conditions such as spinal cord injuries also showing signs of responding to illusion-based treatment.

Reported by ninemsn, 7News, and NT news

Acupuncture research – the path least scientific?

31 October 2012 Neil O’Connell and Lorimer Moseley

A recent, rather flattering, article on acupuncture on this website holds a mirror to a broader problem in the world of acupuncture research. A problem that goes to the heart of the most fundamental scientific principles.

There’s no doubt that acupuncture is gaining traction on the grounds that it holds up under scientific interrogation. But does it really?

Let’s go back to basics. The scientific method involves proposing a theory based on plausible principles, and then trying to disprove it. Let’s say the theory proposes that a particular treatment is effective for a certain condition.

First, we ask whether it’s based on plausible principles. And, if so, we design studies to rule out every possible explanation for the observed effect except the explanation captured in the theory. If the effect remains after all reasonable controls have failed to remove it, we conclude that, on balance, it’s probably real.

Shaky foundations

Acupuncture is based on implausible principles. The concepts of Chi – an invisible, unmeasurable life force, flowing through meridians (unobservable pathways with no known anatomical correlation) – have both an allegorical quality and the appeal of an ancient provenance. But these aren’t held up by anything the scientific method has revealed.

Perhaps despite its implausible principles, acupuncture point combinations are based on centuries of practice and consistent observations of this effect. Very unlikely – we have previously reflected on this. Even limiting the number of needles that are inserted to four (in order to develop crude evidence that specific points are effective for specific ailments) requires an astronomical number of tests.

Let’s presume, for instance, that in China at the time when the first acupuncture tomes were generated with their 400 or so acupuncture points, the average lifespan was 50 years. In order to get all the needle combinations tested, every member of the Chinese population would have had to suffer from the same condition throughout their lifespan, and then receive eight separate treatments a year for every year of their life.

For a number of reasons, this estimate should be considered wildly conservative – and this is for just one condition. Acupuncture is recommended for an astounding range of afflictions.

Research evidence

Ensuring robust double-blinding studies of acupuncture is a tricky business. Nonetheless, good quality trials across a range of clinical conditions and outcomes,overwhelmingly show that acupuncture fails to outperform sham.

To read the full article go to the original article in the Conversation.

Make it Stop – September Issue of Men’s Health Magazine.

September 2012

Lorimer Moseley and James McAuley feature in the September issue of Men’s Health in an article on chronic pain and its management (click on the cover image below to read the article or download the PDF).

grey Media Stories 2012

Mixed Signals – LiveMind, The Wall Street Journal

9 August 2012 Lorimer Moseley

Pain is a protective experience: It’s our brain’s siren call to get us to pay attention to what it perceives as a dangerous situation for the body. If you accidentally sprain your ankle while running, the brain tells you that it hurts so that you tend to your ankle immediately. If you didn’t feel the pain after spraining your ankle, you’d keep running and seriously damage your ankle. “Pain is one of life’s most sophisticated mechanisms, assisting us to successfully navigate our physical environments,” says Lorimer Moseley, professor of clinical neurosciences and chair in physiotherapy, School of Health Sciences, University of South Australia, in an email interview. Sometimes, though, pain can become the illness itself…..

[We'd like to correct one of the paragraphs in the original article:]

…“For example,” says Dr Moseley, “we have experts in pain biology that teach patients about how pain really works. We nearly always have to introduce people to a new way of thinking and we have learnt that the best way to do this is via stories and metaphors. We often need a good psychologist who can help the patient to think differently, to learn skills that make the pain more manageable, to develop other skills that make the long journey to recovery more likely. Then SOMETIMES we need a very astute and informed musculoskeletal physician who can USE RIGOROUS METHODS TO DETECT WHETHER a structure or a nerve IS CONTRIBUTING TO THE SITUATION.

Go here for the complete Mixed Signals article.

Pain really is in the mind, but not in the way you think – The Conversation

7 August 2012 Lorimer Moseley

Everybody hurts, but not everybody keeps hurting. The unlucky few who do end up on a downward spiral of economic, social and physical disadvantage.

While we don’t know why some people don’t recover from an acute episode of pain, we do know that it’s not because their injury was worse in the first place. We also know that it’s not because they have a personality problem. Finally, we do know that, on the whole, treatments for chronic pain are not particularly successful.

This sobering reality draws up some interesting reflections on pain itself. What is pain? Is it simply a symptom of tissue damage or is it something more complex? One way to approach this second question is to determine whether it’s possible to have one without the other – tissue damage without pain or pain without tissue damage.

And you can answer that one yourself – ever noticed a bruise that you have absolutely no recollection of getting? If you answered yes, then you have sustained tissue damage without pain. Ever taken a shower at the end of a long day in the sun and found the normally pleasantly warm water, painfully hot? That’s not the shower injuring you – it’s just activating sensitised receptors in your skin.

Such questions and their answers are of great interest to pain scientists because they remind us that pain is not simply a measure of tissue damage.

What is pain?

The International Association for the Study of Pain defines pain as an experience. Pain is usually triggered by messages that are sent from the tissues of the body when those tissues are presented with something potentially dangerous.

The neurones that carry those messages are called nociceptors, or danger receptors. We call the system that detects and transmits noxious events “nociception”. Critically, nociception is neither sufficient nor necessary for pain. But most of the time, pain is associated with some nociception.

The exact amount or type of pain depends on many things. One way to understand this is to consider that once a danger message arrives at the brain, it has to answer a very important question: “How dangerous is this really?” In order to respond, the brain draws on every piece of credible information – previous exposure, cultural influences, knowledge, other sensory cues – the list is endless.

How might all these things modulate pain? The favourite theory among pain scientists relies on the complexity of the human brain. We can think about pain as a conscious experience that emerges in response to activity in a particular network of brain cells that are spread across the brain. We can call the network a “neurotag” and we can call the brain cells that make up the neurotag “member brain cells”.

For more on this article see Pain really is in the mind, but not in the way you think at the Conversation.

Chronic pain distorts sufferers’ sense of space and time – UniSA news

23rd July 2012 Lorimer Moseley

Einstein’s famous theory of relativity proposed that matter can distort space and time. Now a new study recently published in the journal Neurology suggests that chronic pain can have the same effect.

grey Media Stories 2012

Neuroscientists from the University of South Australia, Neuroscience Research Australia and the University of Milano Bicocca in Italy, studied people with chronic back pain, the most common painful condition which costs western countries billions of dollars in lost productivity every year.

They presented identical vibration stimuli to the painful area and a non-painful area and noted that the stimuli were processed more slowly by the brain if they came from the painful area.

The most striking finding, however, was that the same effect occurred if the stimuli were delivered to a healthy body part being held near the painful area.

Lead author of the study, Professor Lorimer Moseley from the University of South Australia, says it was not altogether surprising that, in people with chronic pain, there are changes in the way the brain processes information from and about the painful body part.

“But what is remarkable is that the problem affects the space around the body as well as the body itself,” Prof Moseley says….

Read the full article at UniSA news releases

Blog Rankings – a different way of measuring impact

2nd April 2012 Lorimer Moseley

Publish or perish’ is the unofficial motto of scientific life. Get your research out there! Get citations! Get your rankings up! But it’s easier in some areas than others, as University of South Australia pain specialist Professor Lorimer Moseley has found.

Moseley, a professor of clinical neurosciences and the university’s first chair in physiotherapy, has spent the last few years undertaking something of an experiment: together with a team of researchers, he runs BodyinMind.org, a blog and website dedicated to getting the latest research in pain management to the people actually using it in the field, not just the people reading journal articles. More here at Campus review

The champion cyclist – The Australian

grey Media Stories 2012

For as long as Amanda Spratt had been riding with the Australian Institute of Sport, she’d had this gnawing demon as a passenger. Picture: Randy Larcombe Source: The Australian

24 March 2012:  …a whole new generation of scientists, doctors and therapists are taking the new understanding of neuroplasticity and asking whether it is the beginning of a revolution that can cure patients such as Amanda Spratt, when all else has failed. After all, they ask, if the brain can change itself, surely it must be possible to convince it to change back? For the full article click here:  The champion cyclist – The Australian

Mind can control allergic response

18th Jan 2012

You – or more accurately, your brain – has control over how allergic your skin is, suggests new research. A team of neuroscientists have found that if someone has a lesser sense of ownership over a part of their body, their immune system also responds differently to that body part, treating it as ‘non-self’ rather than ‘self’. For more see the paper published in Current Biology.  or see the full report  originally published at Neuroscience Research Australia.

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