PhD Studentship: Epidemiology of Pain

College of Life Sciences & Medicine Graduate School

University of Aberdeen

The studentship is being offered in one of three possible areas of pain epidemiology:

- pain in older persons;
- post-surgical pain; or
- pain and pharmacy.

Information

Pain in older persons

Chronic musculoskeletal pain is a common disabling condition, and back pain is among the most prevalent. Recent evidence suggests that while non-specific back pain decreases in later life, the prevalence of disabling back pain continues to increase in older persons. Until we fully understand the epidemiology of pain in this group, it is not possible to design and study effective interventions, and to improve the management of musculoskeletal pain in older persons. The proposed PhD will take advantage of data from a large population-based cohort study of persons aged >75yrs. Specifically, the PhD will determine the role of social networks in maintaining musculoskeletal health; will examine whether exercise and participating in societal activities protect against the development of low back pain – and whether such effects are mediated through mood; and will investigate the relative importance of back pain on health at older ages.

Post-surgical pain

Recent studies have shown structural changes in the brains of people who report chronic pain using magnetic resonance imaging (MRI), such as reduced grey matter volume. This effect is not specific to one type of pain but has been observed in several groups of patients with different types of chronic pain. All studies to date are cross-sectional and therefore it is not clear whether these degenerative changes in brain structure are a result of the pain itself, a consequence of pharmacological treatment or changes in lifestyle (eg reduced physical activity) of the patients. The proposed PhD will examine brain structure in a cohort of patients who have previously undergone surgery. Some will now have developed chronic post-surgical pain and we wish to see whether these patients exhibit different brain morphologies from those who have not developed post-surgical pain. Further, amongst those who have developed chronic pain after surgery we will examine whether there is a relationship between brain structure and drug treatment and/or lifestyle factors. This work will refine our knowledge about chronic pain and biological mechanisms for its development.

Pain and pharmacy

Many epidemiological studies of pain in the general population fail to collect information on analgesic use. Thus, it is not currently known how many people take pain medications, generally, and what the characteristics are of these individuals. In order to determine accurate estimates of pain prevalence, and to assist in the assessment of treatment success (or failure) it is important to examine this in detail. The proposed PhD will determine the best way to measure analgesic use in the general population, suitable for large scale epidemiological studies; will examine the effect of additional data collection on questionnaire response rates; and will provide preliminary estimates on the magnitude of error in epidemiological studies, caused by the absence of this information.