Measuring acute pain and the transition to chronic pain: towards improved diagnosis and management

Identifying pain-related changes to tissue biochemistry to flag patients at risk of chronic pain

During their lifetime, one in five Australians will experience chronic pain, which is defined as ongoing pain for three months or more. Currently, diagnosis of pain relies upon self-reported questionnaires based on the patient’s perceptions of their pain, which can be highly variable from person to person. 

While some patients with acute pain may go on to develop chronic pain, for others their symptoms may improve with treatment, or spontaneously resolve.

If patients at risk of developing chronic pain can be identified, this may provide a window of opportunity to seek appropriate treatment - such as specialist referral, allied health referral, and/or a change to their medication.  

Using MRS to detect progression from acute to chronic pain

Experienced radiographer Julia Watson is embarking on a PhD project to develop a more objective method of identifying patients who are at risk of developing chronic pain - using in vivo neuro two-dimensional (2D) magnetic resonance spectroscopy (MRS) L-COSY.

Using this technique, Julia aims to provide clinicians with an ability to monitor patients for early signs of transition from acute to chronic pain, to help inform their management.  

Previous studies have shown MRS can detect neurochemical changes in patients with different types of low back and spinal cord injury pain. Julia’s project aims to extend and validate this technology for diagnosis of acute and chronic pain via changes to tissue biochemistry, and use it to monitor for the transition from acute to chronic pain.  

Patients will be measured at baseline, then four and eight weeks later to see if any change to their tissue biochemistry can be observed with this technique. These MRS results will then be correlated with results of self-reported pain questionnaires, to determine whether there is an association between tissue biochemistry changes and the patient’s perception of pain. 

Progress to date

Since commencing this project in late 2017, Julia has obtained MRS scan results for several healthy controls, and several patients with acute and chronic low back pain. Pending further results, Julia aims to validate this technology for a potential application in evaluating treatment efficacy, to help improve the management of patients with chronic pain. 

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Project supervisors: Julia’s PhD project is supervised by Professor Carolyn Mountford and Professor Graham Galloway at the TRI, and Professor Pamela Rowntree at the Queensland University of Technology.

Collaborators: This project involves a collaboration with Active Rehab Physiotherapy, and clinicians and surgeons at the Princess Alexandra Hospital (PAH), including the PAH Physiotherapy Department, Emergency Department and Spinal Injury Unit.

Picture: Julia Watson at the Siemens 3Tesla Prisma MRI.​