Striving toward a pain-free future

We've all experienced the aches and pains that come with starting a new exercise program, a fall on the ice, or maybe pushing ourselves a bit too hard one day. While uncomfortable, the pain or stiffness can be relieved with over-the-counter pain medications, time and rest. But for people living with arthritis or another chronic musculoskeletal (MSK) condition, pain is a part of daily life. In fact, if you ask an arthritis sufferer what they find most difficult about their condition, they'll tell you it's the unrelenting physical pain.

To draw attention to the impact of MSK pain on health and quality of life, the International Association for the Study of Pain has launched the 2009-2010 Global Year Against Musculoskeletal Pain. This initiative aims to raise public awareness of MSK pain, educate researchers and health professionals, and encourage research that may produce more effective and accessible treatments.

This is no small problem. In Canada, approximately 100,000 people are diagnosed with arthritis each year. The most common type, osteoarthritis, affects 1 in 10 Canadians. According to the Canadian Arthritis Network, arthritis costs Canadians more than $4 billion each year in health-care expenses and lost productivity. When we add the number of people affected by other types of MSK pain, such as neck, limb, lower back and bone pain, it's clear that by reducing the pain associated with MSK conditions, we will not only alleviate much suffering, we will also dramatically reduce health care costs and the negative impact on our economy.

The Canadian Institutes of Health Research (CIHR) is proud to support Canadian researchers who are improving our understanding of pain in MSK conditions. Their work is leading to new treatments and approaches to managing this type of pain. Over the last five years, funding for MSK pain research through CIHR has more than doubled, increasing to $8.4 million in 2009 from $3.5 million in 2004. In addition, as one of our strategic priorities, the Institute of Musculoskeletal Health and Arthritis is supporting research on pain, disability and chronic disease.

CIHR is supporting research that tackles the complex issue of pain from a variety of perspectives – biomedical, clinical, health systems, social and cultural. Here are a few examples of funded projects:

• The World Health Organization report on the burden of MSK conditions stated, "perhaps the most fundamental difficulty in regard to rheumatic diseases is that the problem is insufficiently appreciated and understood. Critical to this lack of appreciation is an information deficit". Dr. James Henry at McMaster University in Hamilton, ON, is leading a community-based project that seeks to address this deficit by improving the translation of pain research results to benefit patients and their caregivers. He is also developing new targets to alleviate pain by investigating the chemical activation of sensory receptors that carry pain signals to the brain.
• Dr. Jason McDougall at the University of Calgary is leading a project to understand how "good" chemicals involved in our ability to sense pain can turn "bad" and contribute not only to the chronic pain seen in arthritis but participate in worsening the disease by increasing inflammation. His work will also test whether certain medications may be useful in treating both the pain and the inflammation process.
• Dr. John Kowal at The Ottawa Hospital Rehabilitation Centre is studying the role of personal interactions, such as those between a patient and a physician, in the experience of chronic pain and its treatment.
• Dr. Gillian Hawker at the Women's College Hospital, University of Toronto, has studied the biopsychosocial components of pain and fatigue in osteoarthritis patients, identifying pain quality (versus severity), mood and sleep as promising new targets for pain management.

In the end, we want to reduce the devastating effect that MSK pain has on people's health and quality of life. Our vision is to create a pain-free future for all.

Jane E. Aubin, PhD
Scientific Director
CIHR Institute of Musculoskeletal Health and Arthritis