As a charity, one of our 10 goals is to make sure that more people with arthritis will remain active and free from pain.
Our national pain centre
Since 2010 we’ve been funding a national pain centre with the University of Nottingham in a bid to tackle long-term pain, involving clinicians and scientists from different research fields. These experts are working together to research better treatments for arthritis.
The aims over the next five years are:
- looking at pain from a social context; finding out what patients’ understanding of pain is and what they expect from treatment
- investigating closely two forms of pain mechanisms: the role of peripheral pain (pain that comes from the nerves in the joints) and central pain (the way that the brain responds to and processes chronic pain) and trying to produce new compounds that target these pain pathways
- running clinical trials aimed at testing existing drugs and any new painkillers that may be produced over the next five years.
Our research section gives more information about what we’re funding.
Research into the placebo effect
We’re funding some interesting research into the power of the placebo effect (where patients feel an improvement in their symptoms due to the power of suggestion rather than due to the effects of an actual drug). Our research team are giving placebos to volunteers with osteoarthritis and fibromyalgia to find out if they release natural painkillers in the body, known as endogenous pain control mechanisms.
The researchers are using laser stimuli to induce experimental placebo responses in the three volunteer groups. It’s believed that people with chronic widespread pain have abnormalities of how they anticipate and focus on pain and the researchers suggest that this results in them feeling greater pain than other people.
Novel research using mirrors
Our research has shown that mirrors can trick the brain into recovering from severe, long-term pain.
Researchers have found that people with severe pain in a limb (such as complex regional pain syndrome) found relief by looking at a reflection of their healthy limb in a mirror. The reflection of the non-painful limb gives the person the impression of now having two healthy, pain-free, functioning limbs. The treatment is based on a new theory about how people experience pain even when doctors can find no obvious direct cause.
The theory suggests that the brain’s image of the body can become faulty, resulting in a mismatch between the brain’s movement control systems and its sensory systems, causing a person to experience pain when they move a particular limb. Imaging studies have demonstrated that chronic pain reduces activity within the brain’s sensory and motor systems that relate to the painful area. Mirror visual feedback therapy has been shown to reactivate these areas, thereby improving function and reducing pain.
Our research has shown that cognitive behavioural therapy (CBT) provided over the phone can have a positive impact on people suffering from chronic widespread pain compared to usual care provided by their GP.
Patients who received a short course of CBT over the telephone from trained therapists reported that they felt ‘better’ or ‘very much better’ at the end of a six-month treatment period, and also three months after it ended.
Our trial was the first-ever trial of telephone-delivered CBT for people with chronic widespread pain.
Exercise was also shown to improve pain and disability and helped people manage their symptoms.
Much of our research looks at pain at specifics sites. We’ve shown that yoga can help people manage back pain more effectively, and we’re currently investigating acupuncture and the Alexander technique as possible treatments for neck pain.
We’re looking at better ways of managing back pain in primary care by developing a new screening tool for GPs which has been designed to pick up whether a patient’s risk of back pain becoming chronic is low, medium or high – and which is enthusiastically being taken up by GPs around the country. Patients are then offered different treatments, with those at highest risk of their back pain becoming chronic given the most intensive physiotherapy treatment, while those at low risk are encouraged to avoid numerous sessions of treatment that are unlikely to be beneficial.
We’re looking at whether a particular intense form of CBT can help people whose back pain has led them to withdraw from society and normal life, people who are known as ‘fear avoidant’. It’s being compared to physiotherapy. Early results look promising.