President’s Report – September 2016

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Spring has sprung from Parliament House, or maybe it’s a sprung spring. Suggestions about how to use these tensions to further the community recognition and awareness of pain and its efficient management gratefully received!

ASEAPS 2017, Myanmar

This biennial pain conference of the Association of South-East Asian Pain Societies (5 countries) will be held in Myanmar February 17-20, 2017. As we have done at the last two ASEAPS Congresses, the APS is donating a prize for the best free paper or poster at that meeting. The Award, which is much appreciated by their organisers, includes a contribution to travel and accommodation and complimentary conference registration to one of our future APS Annual Scientific Meetings. I anticipate attending this event, as have our previous President Tim Semple (2013), whose initiative this is, and Prof Stephan Schug (2015), to present this Award, and further our developing linkages with Asia. I would love to meet up with any of our members who may be attending.

IASP World Congress 2016, Yokohama

As always this promises to be an awesome event. There is so much packed into those 5 days and all those attending will benefit from the experience. Just by the way, if attending neuropathic pain events think carefully about what exactly is the meaning of, and clinical manifestations of, ‘neuropathic pain’. Would it be better thought of in terms of ‘high volume’ nociceptive transmission with the prime clinical manifestations being (almost) solely the features of central sensitisation? Where exactly in the c-fibre (Na channels aside) are we actually treating neuropathic pain? Express the Australian in you and agree that it may be all a ‘furphy’!? Enough said, for now.

By the way, did you see the IASP members’ information recently which showed that the country with the 3rd largest number of IASP members is Thailand? I look forward to finding out how they achieved this impressive ranking. Great effort!

We hope to impress upon the IASP leadership the many benefits of convening a future World Congress on our welcoming shores.

Our Membership

As you all continue to encourage increased membership have a look at some interesting graphs and charts (at 29AUG16) of the age and gender distribution of our colleagues in this 37 year old organisation. This is reflected in the composition of your Board. We hope there are plenty of aspiring members out there who could be tempted to more actively participate in the evolution of Your Society.   aps-members_age-gender_aug16

APS/NZPS 3rd Conjoint ASM, Sydney, April 2018 (weekend after Easter)

The Memorandum of Understanding between the Societies is nearing finalisation. Put this in your diary and in everyone else that you know- we are aiming for 1,000 attendees!! Need to re-balance that All Blacks scorecard….

1,000 Members …..

Whilst contemplating ‘una mille’ all current 850+ members are encouraged to inspire ‘should-be’ members to join our highly successful and highly-esteemed Society ….. there will be a celebratory event and prize for the ‘1,000’ milestone. Please write in with your suggestions!

Thought Bubbles ….

OK, so these reflect my interests and clinical experience but discuss over morning tea….

  • The evidence for the greatest pain reductions, over sustained periods, in the ‘ouch’ of pain (see Davis commentary in 2015 Nov;156(11):2164-6 : “The intensity and quality of pain certainly colors the experience and gives it meaning, but these features are secondary to the fundamental presence of the “ouch” itself that signifies primary sense of pain. The pain switch can be thought of like a light switch. There is light as long as it is turned on to keep a circuit functioning, but there is no light when the switch is turned off or the circuit is interrupted.”)

Where are we in our understanding of the Pain Switch, which in my experience can arise from neurotomies, some epidurals, neuromodulation especially spinal stimulation and, dare I say it, a range of medications. Patients don’t come back, to me at least, even after years, for more CBT, Mindfulness, exercising, graded motor imagery, return-to-working stuff- it is for that other stuff ….. so with all the undoubted benefits of brain-based therapies, one can’t throw out the baby (i.e. non-harmful medical options) with the bathwater….

“Chronic back problems are long-term health conditions that include specific health conditions such as disc disorders, sciatica, and curvature of the spine, and back pain or problems that are not directly associated with a specific disease (such as osteoarthritis).”

This to me is a nonsense perpetuating myths and should be relegated to ‘the dustbin of history’ along with the expression of ‘non-specific low back pain’ at least in educated audiences. The phrase should be ‘undiagnosed low back pain’. (Note: NOT ‘undiagnosable’!).

Perhaps this is because the two data sources, being the Australian Bureau of Statistics (ABS) National Health Survey (NHS) 2014–15, and the ABS 2012 Survey of Disability, Ageing and Carers (SDAC) both have poor coding of pain and pain diagnoses.

Discuss!

Wishing you all a great World Congress of Pain in Yokohama!