Our research in the

Intervention Testing theme

The Intervention Testing theme includes research staff, research students and professional staff from a variety of backgrounds including physiotherapy and pharmacy.

When patients seek treatment, they want an intervention that helps them get better (effective), has minimal or manageable side effects (safe), and justifies the money they spend (cost-effective). Providing effective, safe and cost-effective treatments is important to clinicians, health funders and patients. In the Intervention Testing theme, we rigorously evaluate whether treatments are effective, safe and cost-effective to continuously improve the care that patients receive.

Our research has improved the management of musculoskeletal conditions. For example, we have found that for people with certain injuries (chronic whiplash or ankle fracture), simple advice from the physiotherapist is just as effective as a structured exercise program. We have also found that some medicines – such as pregabalin – are not effective and may be harmful in back pain conditions, and this has changed the way these medicines are being recommended in practice.

IMH-led projects

We hope the findings of this project lead to an effective treatment for acute low back pain through reducing pain, increasing mobility, and decreasing use of pain medication.

The aim of this project is to test the effectiveness of a heat wrap therapy by measuring the patient’s use of analgesic medications, clinical outcomes, and adverse events. The participants will wear the heat wrap during waking hours for up to 7 days. Participants will be asked to complete a pain diary over the course of the trial.

This study is currently recruiting. Adult patients will be eligible for this project if they have acute non-specific low back pain of at least moderate pain intensity, and have not previously tried heat wrap therapy for their low back pain.

Principal Investigator: Dr Christina Abdel Shaheed (IMH)

Chief Investigators: Professor Christine Lin (IMH), Dr Stephanie Mathieson (IMH), Professor Chris Maher (IMH), Dr Gustavo Machado (IMH), Dr Fiona Stanaway (University of Sydney), Professor Andrew McLachlan (University of Sydney), Professor Ric Day (University of NSW), Professor Jane Latimer (IMH), Dr Adrian Traeger (IMH).

For more information about this project, please contact Dr Christina Abdel Shaheed. This study has received ethics approval from the University of Sydney Human Research Ethics Committee and funding from the Sydney Musculoskeletal Bone and Joint Health Alliance.

ACTRN12618000270213

This project will provide the first robust evidence on the effectiveness of opioids in the treatment of acute low back pain and neck pain. The trial results will improve care for patients suffering acute spinal pain.

Low back pain and neck pain place an enormous burden on patients and health services, both nationally and internationally. Despite the widespread use and recommendations in clinical guidelines, there are no randomised controlled trials that have assessed the effectiveness of opioids for acute low back and neck pain. OPAL is a clinical trial to find out whether opioid analgesics are effective in reducing low back or neck pain, compared to placebo. The opioid analgesic medication– oxycodone – will be taken for up to six weeks. During these six weeks, the participant will be reviewed weekly by a treating physician.

This study is currently recruiting. You may be eligible to participate if you have experienced low back pain and/or neck pain of at least moderate severity within the last 12 weeks, and are considered by your treating doctor as appropriate for opioid analgesia.

Principal Investigator: Professor Christine Lin (IMH)

Chief Investigators: Professor Chris Maher (IMH), Professor Jane Latimer (IMH), Associate Professor Laurent Billot (University of Sydney), Professor Andrew McLachlan (University of Sydney), Professor Ric Day (University of NSW) and Professor Bart Koes (Erasmus University Medical Centre, University of Southern Denmark).

For more information, please contact the OPAL team. The sponsor of this trial is the George Institute. The study has received ethics approval from the University of Sydney Human Research Ethics Committee. OPAL is funded by the National Health and Medical Research Council.

ACTRN12615000775516

We hope the findings of this project provide strategies to prevent the recurrence of low back pain.

The TOPS Trial aims to assess the effectiveness and the cost-effectiveness of exercise and educational classes compared with a back care booklet, for reducing recurrence of low back pain. Participants are randomly allocated to one of two groups: participants allocated to the exercise and education group attend a group-based exercise and education program for 12 weeks, and participants allocated to the booklet group receive a self-management and prevention booklet. You may be eligible to participate in this study if you have recently (within the last three months) recovered from an episode of low back pain.

Principal Investigator: Professor Chris Maher (IMH)

Co-Investigators: Associate Professor Mark Hancock (Macquarie University), Associate Professor Charles New (University of Sydney), Professor Jane Latimer (IMH) and Mr Giovanni Ferreira (IMH).

Associate Investigators: Professor Rachelle Buchbinder (Monash University), Professor Mauritis van Tulder (Vrije University, University of Southern Denmark), Professor Christine Lin (IMH) and Professor Margareth Grotle (Keele University).

For more information, please contact the TOPS team. The study has received ethics approval from the University of Sydney Human Research Ethics Committee and is funded by WorkCover NSW.

ACTRN12615000939594

This project aims to investigate the effects of oral glucocorticoids in people with acute sciatica. There is currently no simple, effective treatment to relieve the pain in acute sciatica.

Acute sciatica is a prevalent, debilitating pain condition. Preliminary evidence suggests that taking oral glucocorticoids may relieve pain and improve function in acute sciatica. The OASIS clinical trial will evaluate whether oral glucocorticoids are effective and safe compared to placebo. The medication will be taken for up to 2 weeks. Participants will be followed up for one year to measure leg pain intensity and other important outcomes. We will also assess drug safety and evaluate cost-effectiveness.

This trial is in an early phase and not yet recruiting. However the research team is looking for General Practitioners who are interested in research to be involved with the recruitment of patients with sciatica into the OASIS study.

For more information, please contact Dr Juliana Oliveira

The sponsor of this trial is The University of Sydney. OASIS is funded by the National Health and Medical Research Council.

Principal Investigator: Professor Christine Lin (IMH)

Chief Investigators: Professor Andrew McLachlan (University of Sydney), Professor Jane Latimer (IMH), Dr Christina Abdel Shaheed (IMH), Mr Qiang Li (The George Institute)

Associate Investigators: Dr Bethan Richards (IMH), Professor Rachelle Buchbinder (Monash University), Professor Chris Maher (IMH), Professor Ric Day (University of NSW).

Collaborative projects

The intention of the trial is to validate a new treatment approach for chronic low back pain leading to clinically meaningful reduction in pain intensity at six weeks post treatment.

The RESOLVE Trial aims to test two interventions targeting the brain to treat chronic low back pain. New research shows that it may be possible to retrain the brain to reduce chronic low back pain. Participants are allocated to one of two intervention groups, both attending 12 one-hour treatment sessions. The first intervention program will include: discussion of your low back pain; laser therapy and pulsed electromagnetic energy for your lower back, non-invasive brain stimulation; mental movement training; physical movement training; and training to improve your sense of touch. The second intervention program will include: low back pain experience, transcranial direct current stimulation, cranial electrical stimulation, low-intensity laser therapy and pulsed electromagnetic energy.

This project is currently recruiting. You may be eligible to participate in this study if you have low back pain for longer than three months, between 18 – 70 years old and live in the Sydney metropolitan area.

Principal Investigator: Associate Professor James McAuley (NeuRA)

Institute for Musculoskeletal Health Investigator: Professor Chris Maher

For more information on this NeuRA trial, please contact the RESOLVE team on 02 9399 1627. This NHMRC Project Grant has received ethics approval from University of New South Wales Human Research Ethics Committee.

ACTRN12615000610538

The intention of the trial is to validate a new treatment approach for chronic low back pain leading to clinically meaningful reduction in pain The intention of the trial is to demonstrate McKenzie based self-management as a low-cost, simple method for reducing the burden of low back pain.

The SAFE Trial aims to assess the effectiveness of McKenzie based self-management in reducing the recurrence of low back pain. While the recurrence of low back pain is very common, there is limited evidence on interventions that are effective in preventing relapse. Participants are randomly allocated to one of two treatment groups: participants allocated to the intervention group attend two 30 minute sessions with a physiotherapist and participants allocated to the control group receive advice over the phone and a self-management booklet.

This study is currently recruiting. You may be eligible to participate if you have recovered from an episode of non-specific low back pain in the past six months, are 18 years or older and not taking any medication for low back pain.

Principal Investigator: Associate Professor Mark Hancock (Macquarie University)

Institute for Musculoskeletal Health Investigator: Professor Chris Maher

For more information on this Macquarie University trial, please contact Mr Tarcisio Folly de Campos. The study has received ethics approval from Macquarie University Human Research Ethics Committee and funding from the International Mechanical Diagnosis and Therapy Research Foundation.

ACTRN12616000926437

The aim of this trial is to compare the effectiveness of a single ultrasound-guided injection of platelet-rich plasma (PRP), glucocorticoid or saline (placebo) for the treatment of Tennis Elbow. In addition, the trial is aiming to compare the cost-effectiveness of these treatments. Lateral epicondylitis or tennis elbow is a common musculoskeletal condition which affects 15% of workers in at-risk industries. The high costs to the individual and society – related to sick leave and disability – demonstrate a clear need to assess the most cost-effective therapies. Participants will be screened including an ultrasound performed to confirm the diagnosis, to ensure that they are eligible for the study. Outcomes will be assessed at baseline and multiple time points over a year.

This study is currently recruiting. You may be eligible to participate if you have experienced lateral elbow pain for six weeks or more and have an ultrasound-confirmed lesion.

Principal Investigator: Prof Rachelle Buchbinder (Monash University)

Institute for Musculoskeletal Health Investigator: Dr Bethan Richards

For further information about this Monash Department of Clinical Epidemiology at Cabrini Hospital trial, please contact Dr Allison Bourne. The study has received ethics approval from Cabrini Human Research Ethics Committee and has received NHMRC funding.

ACTRN12613000616774

The intention of the trial is to prevent recurrences of low back pain through determining if a progressive individualised walking and education program is more effective when compared to usual care, in preventing recurrence of low back pain in people recently recovered from an episode of non-specific low back pain.

Participants will be randomly allocated to one of two groups. One group will receive a walking and advice intervention delivered by a physiotherapist (3 face to face/video conferencing and 3 over the phone consultations, at no cost) and the other group will receive usual care which does not involve any intervention as part of the trial.

This project is currently recruiting. You may be eligible to participate in this study if you live in Australia and have had an episode of low back pain in the last 6 months

Principal Investigator: Professor Mark Hancock

Institute for Musculoskeletal Health Investigators: Professor Jane Latimer, Professor Chris Lin, Professor Chris Maher, Associate Professor Anne Tiedemann.

For more information on this Macquarie University Trial, please visit the WALKBACK website. This NHMRC funded project has received ethics approval from Macquarie University Human Research Ethics Committee.

ACTRN12619001134112

Theme leader: Professor Christine Lin

BAppSc, BPhty, PGDipHSc, PhD

Professor Christine Lin is a Principal Research Fellow at the Sydney School of Public Health and holds a Career Development Fellowship from the National Health and Medical Research Council. Her research investigates the effectiveness, safety and cost-effectiveness of treatments for people with musculoskeletal conditions, and she has a particular interest in the pharmacological management of back pain. Professor Lin leads several clinical trials and has published in journals such as New England Journal of Medicine, Lancet and JAMA. She has a professional background in physiotherapy.