by Kyle Vader, PT, MScPT
World Physical Therapy Day, hosted by the World Confederation for Physical Therapy, takes places on the 8th of September each year. While last year focused on the role of physiotherapy and physical activity for mental health, the theme for this year’s World Physical Therapy Day is chronic pain. Special shout-out to Canadian physiotherapist Dr. Lisa Carlesso, Assistant Professor at McMaster University, who contributed her content expertise to make the toolkit materials for World Physical Therapy Day a success!
This year’s campaign emphasizes the following key messages:
- Exercise therapy is included in all guidelines for the treatment of chronic pain
- The brain plays an important role in chronic pain
- It’s important to dispel myths associated with chronic pain
- Exercise is beneficial and physical therapists play an important role in developing patient-centered activity and exercise programs
- Physical therapists helps people with chronic pain develop the skills they need to manage and take control of their condition.
You can find more information and promotional materials for World Physical Therapy Day by clicking here.
While World Physical Therapy Day is a global initiative, this shoPTalk blog will focus on providing a broad overview of the current landscape of chronic pain research and clinical care in the field, with a specific focus on the Canadian context. I can’t help but feel that it’s an exciting time for pain research and care in Canada - whether you consider the announcement of the Canadian Pain Task Force, recent research funding successes by physiotherapy and pain researchers, changes to the ICD-11 codes for chronic pain, or an increasing recognition on the importance of improved access and funding to chronic pain care, including improved access to evidence-based services not routinely covered by the publicly funded healthcare system, such as care provided by physiotherapists.
At the 40th Annual Scientific Meeting for the Canadian Pain Society this past April, The Honourable Ginette Petitpas Taylor, Minister of Health, announced the formation of a Canadian Pain Task Force. Co-chaired by Dr. Fiona Campbell, Paediatric Anesthesiologist and President of the Canadian Pain Society, and Maria Hudspith, Executive Director of Pain BC, the Canadian Pain Task Force seeks to better understand and address the needs of Canadians living with chronic pain. You can read the first (of three) reports released by the task force by clicking here. You can follow updates on work done by this task force by using the hashtag #CanadianPainTaskForce on Twitter and other social media platforms. Of special note, Melissa Anderson, Advocacy Officer of the Canadian Physiotherapy Association, is a core member of this task force.
In recent months and years, there has been tremendous success by Canadian physiotherapy researchers in the field of pain. For example, Dr. Jordan Miller, Assistant Professor at Queen’s University and a previous Chair of the Pain Science Division, was recently awarded a Project Grant from the Canadian Institutes of Health Research (CIHR) valued at over 1.4 million dollars to explore the impact of a physiotherapist-led primary care model for back pain. Dr. Joy MacDermid, Professor at Western University and McMaster University, was also awarded a CIHR Foundation Grant valued at over 1.3 million dollars to test innovations in the assessment and management of musculoskeletal injury, pain and arthritis. Drs. Dave Walton and Joy MacDermid are core members of the CIHR-funded Chronic Pain Network, an initiative supported by the Strategy for Patient Oriented Research in Chronic Disease, valued at almost 12.5 million dollars over 5 years. Research trainees have also achieved success, including Dr. Simon Décary, a post-doctoral researcher at Université Laval, who was recently awarded a prestigious Banting Fellowship from CIHR to support his research on shared decision making to promote high-quality primary care management of musculoskeletal disorders. This is by no means an exhaustive list, although it’s clear that physiotherapy researchers are contributing to scientific advancements in the field of chronic pain in Canada (and beyond).
Earlier this year, the International Association for the Study of Pain released a new classification system for the International Classification of Disease (ICD-11). Of note, chronic pain is now a parent code for seven other common chronic pain conditions, including:
- chronic primary pain
- chronic cancer-related pain
- chronic post-surgical or posttraumatic pain
- chronic neuropathic pain
- chronic secondary headache or orofacial pain
- chronic secondary visceral pain
- chronic secondary musculoskeletal pain
A key component of this new ICD-11 classification system is that chronic pain can be classified as either primary or secondary, whereby chronic pain can be a disease in its own right. You can find specific details of this new classification system in an issue of PAIN, the Journal of the International Association for the Study of Pain, by clicking here.
Finally, a recent report conducted by the Angus Reid Institute titled Canadians in Chronic Pain: Cost, access to treatment pose significant barriers for those suffering the most, highlighted important data on the lack of access to treatments for people living with chronic pain in Canada. A key message from this report was that “Canadians are near-unanimous (92%) in their agreement that those living with pain should have access to pain treatment that works for them, regardless of income.” In particular, the report found that “two-thirds (66%) of those in the moderate pain group and three-quarters (75%) of those in the severe pain group believe they would be living with less pain today if they could afford to pay for more of the available treatments.” It’s clear that we, as physiotherapists, need to fight for improved access to care for people living with chronic pain. You can find the full report by clicking here.
If you want to learn more about chronic pain, consider becoming a member of the Pain Science Division of the Canadian Physiotherapy Association and attending the 3rd Pain Unconference in Montreal on September 28th, 2019 (to register, please click here). If you’re looking for a broader network of interprofessional clinicians and researchers in Canada, you might also consider joining the Canadian Pain Society, the Canadian chapter of the International Association for the Study of Pain (for more information, please click here).
Bio: Kyle Vader is a physiotherapist in an interprofessional chronic pain clinic at Kingston Health Sciences Centre and a PhD student in Rehabilitation Science at Queen’s University. His clinical and research interests focus on pain, primary health care and knowledge translation. Kyle is actively involved in his community, currently serving as District President of the Quinte-St. Lawrence District of the Ontario Physiotherapy Association, as well as Trainee Representative on the Leadership Team of the Canadian Pain Society. You can reach him by email at firstname.lastname@example.org or on Twitter (@vader_kyle).