Regional and Widespread Pain - Keele University
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Primary Care & Health Sciences

Regional and widespread pain

Our research is not limited to back pain and osteoarthritis, but addresses a range of other musculoskeletal conditions, including early identification in primary care of common inflammatory arthropathies (such as gout, ankylosing spondylitis, rheumatoid arthritis) and primary care management of regional pain problems (such as neck pain, shoulder pain, or tennis elbow). These studies are often based on questions that arise from clinical practice, and are posed by clinicians participating in our Evidence-Based Practice groups. In many people pain is not limited to a single site like the back, knee or shoulder. Most people report diffuse pain or multiple pains, with an increasing number of pain problems being associated with poorer physical functioning, more feelings of anxiety and depression, sleeping problems, and health care resource use.

Given the wide range of pain problems and the high prevalence of multisite pain the Consortium is supporting the development of prognostic tools and Patient Reported Outcome Measures (PROMS) that can be applied across a range of musculoskeletal conditions and which can be usefully applied during the consultation to estimate prognosis and monitor patient progress.

Patients with more complex, persistent or widespread pain problems are often referred to secondary care. The Centre has contributed to the establishment of local musculoskeletal services based at the primary-secondary care interface and aims to describe the characteristics of patients referred from primary care to this service, the interventions they receive, and the clinical outcome of these referrals.

Our current regional and widespread pain studies:

Observational studies

  • A new patient reported outcome measure for musculoskeletal pain (PROMs)
    Funded by the NIHR Research for Patient Benefit Scheme 2011 - 2014
  • Patient outcomes following referral to a musculoskeletal interface service (SAMBA)
    Funded by Arthritis Research UK Clinical Academic Collaboration grant (2007 – 2009)
  • Early Identification of Polymyalgia Rheumatica in Primary Care
    Funded by an Arthritis Research UK Clinician Scientist Award
  • Optimising management of gout in Primary Care
    NIHR     National School of Primary Care Research Project Grant

Randomised clinical trials

  • Exercise and injection for subacromial impingement syndrome (SUPPORT)
    Funded by the NIHR Research for Patient Benefit Scheme 2010 - 2013
  • TENS and advice for tennis elbow (TATE)
    Funded by the NIHR Research for Patient Benefit Scheme 2009 - 2012