It’s an insidious problem that’s often dismissed, but chronic pain impinges on the lives of more than 3.2 million Australians. This number is forecast to swell to 5.2 million by 2050.
Unless Prof Mark Hutchinson has anything to do with it, that is. The director of the ARC Centre of Excellence for Nanoscale BioPhotonics (CNBP) is changing how we view and treat chronic, or persistent, pain — and that goes for livestock wellbeing, too.
Today, Prof Hutchinson also heads the University of Adelaide’s Neuroimmunopharmacology lab. But when he was a PhD student at university in the early 2000s, he developed chronic pain after being flung over his bicycle handlebars.
His lower back pain persisted for 4 years.
‘I still functioned, but there were days when it was just too painful to do much,’ he says, grimacing at the memory. ‘It was freaking frustrating.’
He recovered after restarting physical activity — literally getting back on the bike — coupled with training himself to think differently about the pain. He knew the initial injury had long healed; there was no real reason for his back to hurt anymore. Eventually, the pain faded.
Around that time, researchers were considering chronic pain as a complex condition, beyond physiological factors. Current models encompass physical, psychological, social and environmental elements. No two patients are the same.
Despite this, chronic pain is still generally treated like its acute counterpart: with medications, such as opioids, that can provide short-term relief but, paradoxically, cause long-term harm.
To revise clinician and patient attitudes to chronic pain, Prof Hutchinson and his crew are developing methods that identify chronic pain and treat it quickly and appropriately.
They’re working with colleagues in Australia and the US in the hope that a pain test will one day be part of a clinician’s toolkit.
Then there’s treatment. Instead of analgesic drug quick fixes — which don’t work for everyone — Prof Hutchinson envisions personalised pain therapies that take factors like genetics into account and target highly specific disease sub-groups.
‘Where it gets exciting is a test that can diagnose you with chronic pain but also tells the doctor that you would best respond, from day one, to a particular combination of medicines or mental and physical therapies,’ he says.
Even though human pain relief over the past decades has left a lot to be desired, Prof Hutchinson has noticed history repeating in the livestock industry.
‘We tried to cover human chronic pain with the wrong drugs, and I can see veterinary medicine is heading in that direction now.’
That’s why he’s now broadening his chronic pain work to include quadrupeds.
‘We need to put livestock care on a new trajectory so veterinary medicine can learn from our last 10 years of mistakes in humans,’ Prof Hutchinson says. ‘And we’ll do this by creating the science — the cold hard facts — that underpins quality decision-making.’