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Online initiative easing musculoskeletal pain

The painHealth website
Photo: The painHealth website
With an extensive clinical and research background in musculoskeletal pain, Helen Slater knew many health consumers were struggling to access the essential information and skills needed to assist them with their pain management.

But the overwhelming difficulties for patients really hit home for the Associate Professor of the School of Physiotherapy and Exercise Science at Curtin University, when she began interviewing patients about their musculoskeletal pain as part of a pioneering initiative to address the service gap.

“It’s knowing the burden. We understand the prevalence, the epidemiology, and the cost but the poor person on the ground, they don’t know where to go, they don’t know who to trust,” she says.

“There’s a general lack of understanding, and they just slowly withdraw from their lives - their lives are on hold.
“So it’s about trying to break through and really put something out there that gets past barriers that might be imposed by health professionals or health systems, stopping people from getting helpful, reliable information.”

Assoc. Professor Slater, a specialist musculoskeletal physiotherapist, and her project co-leader Dr Stephanie Davies, a pain medicine specialist, joined forces with a multidisciplinary team of clinicians, researchers and health policy professionals, including pain medicine specialists, rheumatologists, neurologists, physiotherapists, occupational therapists, psychologists and nurses, to develop an innovative website, painHealth.

The site, launched in 2013 and recently updated, is designed to provide health consumers with access to reliable, practical and usable evidence-based information, tips, support and personal stories to assist them to manage their musculoskeletal pain.

The website, developed in partnership with the WA Department of Health, the University of Western Australia and Fremantle Hospital, aligns with models of care developed by the Musculoskeletal Health Network and other strategic frameworks for musculoskeletal health, including the National Pain Strategy, and features recommendations from the International Association for the Study of Pain, including the Declaration of Montreal.

Assoc. Professor Slater says persistent musculoskeletal pain is a debilitating and common condition, affecting about one in five Australians, and costs the economy about $54 billion every year.

“It’s absolutely massive. It’s a very common problem in the broader community but that sort of pointy end of the triangle where most health services are being used are those who have moderate to severe pain that’s not well managed or understood in the broader community nor by many health professionals,” she says.

“We did a considerable body of work prior to this particular initiative with the WA Department of Health. It became apparent as we moved out of metro areas and into some of the regional and remote parts of WA, that there was a real gap in services, and we are very mindful of that, particularly given the context of musculoskeletal pain.

“We were trying to derive something here that would be a reliable and a really practical resource for people who have pain, where they could freely get useful tools and tips no matter where they lived and access helpful content 24/7.”

The first of its kind in Australia, the website was designed for Western Australian residents but has exceeded its original intention and is now a success on the international stage - receiving over eight million hits to date, and a total of 620,000 visitors, from over 150 countries right across the globe.

Assoc. Professor Slater says the website has been a success, largely because of the project’s focus on engaging people with pain as key members of an external reference group, right from the project’s inception.

“A lot of the time in health, people don’t actually ask health consumers what they might want, and their voice was very loud about what content should be there and the nature of the content,” she says.

“For example - ‘we’d really like to hear narratives from people who have different sorts of pain and what the barriers are for them and how they’ve managed it’.

“We did a lot of work on interviewing a whole range of people who lived through the typical sort of musculoskeletal pain conditions that attract the most burden, so osteoarthritis, low back pain, neck pain, rheumatoid arthritis.

“I think that was a really powerful lever because those YouTube clips are short - about five minutes long, edited down from about 40 minutes of content.

“They’re authentic because they come from people who’ve lived those experiences - you can’t replicate that through any expert, it’s just got a voice of its own, it resonates with people who’ve lived with those things, they really get it and they go - ‘that’s me’.”

The website was built around the principles of self-care and takes a whole of person approach, covering sleep, mood, immunity, nutrition and exercise, and features a safe and reliable evidence-based suite of information and tools in a simple, user-friendly format, while also including links to references.

“A lot of the time you might need three or four key things to manage your pain and this website says - here are some of them, here’s how you can use them,” Assoc. Professor Slater says.

“We’re not saying you don’t need other care. We’ve built self-checks into the system that might help to guide people through to their health professional if they’re at risk of serious depression or the mood is so low that you’re worried about suicide or perhaps they’re using medicines inappropriately, mixing alcohol and other stuff.

“So we’ve looked at ways we can capture those higher risk people. Importantly, on this update now, they can do those little quizzes on their phone and they can push that notification to their health service provider or they can print it out and take it, that says - ‘here’s a validated tool saying I’m at risk, I need help, can you help me here?’

“That’s pretty important because sometimes health professionals don’t understand why pain is ongoing, they don’t understand it can make people feel isolated or suicidal, they don’t understand their medicines if they’re mixed with alcohol can be really dangerous, so these are important things for self-care but also to drive the consumer to take things to the health professional and say - ‘hang on, look at this, I need help’.”

In the lead up to National Pain Week, from July 24-30, Assoc. Professor Slater is encouraging physiotherapists and their patients to visit the site, and tap into its range of resources and benefits.

“Hop on, have a look around, there is heaps of content there, but at the end of the day, it’s there as a resource to help you to help your patients.”


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Karen Keast

Karen Keast is a freelance health journalist who writes news and feature articles for HealthTimes.

Karen regularly writes for some of Australia’s leading health news websites and magazines.  In a media career spanning 20 years, Karen has worked as a senior journalist in newspapers and television. She has covered the grind of daily news and worked as a politics reporter at countless state and federal elections.

Since venturing into freelance writing five years ago, Karen has found her niche in writing about the health sector for editors, businesses and corporations.

Karen has interviewed the heads of peak health organisations in Australia and overseas, and written hundreds of news and feature articles covering the dedicated work of health professionals who tread the corridors of hospitals and health services, universities, aged care facilities and practices, day in and day out.

Follow Karen Keast on Twitter @stylemywords