Persistent pain (often referred to as "chronic pain") is pain that continues for three months or more, and does not respond to usual medical treatment.  While other research teams have been documenting the impact of persistent pain on recovery and return to work, and identifying the factors that lead to its onset in the first place, ISCRR researchers from the Evidence Review Hub have been evaluating existing treatment options for persistent pain.

ISCRR researchers have produced a series of evidence reviews in this area, in direct response to requests made by WorkSafe and the Transport Accident Commission (TAC). The objective of this work is to help these compensation bodies maximise the health outcomes of claimants with persistent pain.

The first reviews were produced in 2011, after the Health Services Group (a former joint initiative of WorkSafe and the TAC) requested more information about evidence surrounding the effectiveness of the following clinical treatment options:

  1. Radiofrequency denervation (passing current through tissue adjacent to the target nerve to interrupt the transmission of pain signals)
  2. Intrathecal infusions (implanting a pump containing medication under the skin over the stomach)
  3. Neurostimulation (implanting a device under the skin through surgery, before directing electricity through it onto the nerve associated with pain)

Also in 2011, ISCRR in collaboration with the Health Services Group wanted to investigate whether psychosocial interventions were effective in the treatment of persistent pain. ISCRR researchers set about evaluating evidence suggesting that mental health is associated with persistent pain, and assessing current best practice psychosocial interventions.

In 2012, in response to growing consumer sentiment that firmer mattresses were "better for recovery," the Health Services Group requested a review into the relative impact and effect of beds and mattresses on the clinical course of back pain.

In 2013, as part of a larger clinical evaluation of surgery outcomes, WorkSafe and the TAC requested that ISCRR review evidence concerning spinal fusion.

WorkSafe and the TAC subsequently requested updates to ISCRR's original reviews of radiofrequency denervation, intrathecal infusions and neurostimulation, as well as a review of the relatively new treatment of platelet rich plasma or whole blood injections for treating epicondylitis.

The following papers have been published:

Significantly, the initial and updated reviews of radiofrequency denervation, neurostimulation and intrathecal infusions have all led directly to new treatment policies and practices at the TAC.