Chair up to challenge of easing pain for millions

Paul Mayne // Western News

Along with holding the James Roth Research Chair in Musculoskeletal Measurement and Knowledge Translation at Western, School of Physical Therapy professor Joy MacDermid is also lead investigator with the newly created Canadian MSK Rehab Research Network.

To move freely and without pain. Such a simple wish that goes unrealized for the 1.7 billion people around the world suffering from musculoskeletal disorders of the bones, joints and muscles. These conditions don’t discriminate. They can impact anyone at any age, on any continent, in any community, at any time.

And at some point, everyone will be affected.

Joy MacDermid not only knows the problem, she understands the solution requires a level of cross-discipline, cross-country collaboration never seen in Canada. Yet, she is up for the challenge.

As lead investigator with the Canadian MSK Rehab Research Network, MacDermid is working with a cross-Canada team of more than 80 researchers and collaborators, as well as 20 partners/consumer groups, to solve problems with bones, joints, muscles and nerves. For her, and her colleagues, it is all about helping people move and interact with the world pain free.

Supported by funding from the Canadian Institutes of Health Research (CIHR) Institute for Musculoskeletal Health and Arthritis in 2016, the Rehab Research Network is administered out of Western’s Bone and Joint Institute.

Established in 2015 with a vision of lifelong mobility, the Bone and Joint Institute at Western brings together a group of more than 145 researchers and trainees across disciplines dedicated to leading in musculoskeletal health research, innovation and education. By administering the Rehab Research Network, Western will help define the next generation of musculoskeletal research in Canada, MacDermid said.

“The focus of the network’s initial grant is not to do the research – it is to catalyze it,” she explained, noting to create focus and facilitate impact the network has three research groups centred on the network’s strategic priorities including pain, mobility and work.

“So far, we have run a competition for grants for investigators to apply for. The idea is to bring people together and distribute the funds with the hope the smaller pilot projects that will lead to bigger research ideas down the road.”

MacDermid is Western’s James Roth Research Chair in Musculoskeletal Measurement and Knowledge Translation. The School of Physical Therapy professor’s personal research focuses on the prevention, assessment and management of musculoskeletal injuries and disorders.

Her network co-investigators include fellow Physical Therapy professor Trevor Birmingham, Jean-Sebastien Roy from Laval University, Janie Wilson from Dalhousie University and Stephen Robinovitch from Simon Fraser University.

And their work could hardly be more relevant.

In Canada, musculoskeletal conditions – including arthritis, osteoporosis, skeletal fractures, back pain, trauma, as well as many sport-/work-related injuries – represent the most common medical causes of long-term absences from the workplace. They are the second most common reason for consulting a physician and the leading cause of disability and reduced quality of life.

For some, routine tasks such as brushing teeth and getting dressed can be daily hurdles. For others, aching backs or joints impair walking, sitting and even sleeping. Loss of mobility cause major restrictions on full-time work and once-loved activities with family and friends. This can cause stress and isolation that compromises mental health and wellbeing.

Beyond the personal pain, bone-and-joint disorders are a growing economic burden. Associated costs have increased by 45 per cent over the last 20 years, reaching the present rate of $33 billion per year in health-care expenditures and loss of productivity in Canada alone.

Older adults have an amplified risk for developing musculoskeletal conditions. Thus, as our aging population grows, so too does the prevalence of musculoskeletal issues, with the number of Canadians afflicted expected to climb to 15 million within the next 15 years.

MacDermid has numerous active studies indirectly and directly linked to solutions for these sufferers – one looking at how gender affects pain responses after injury or surgery, another eyeing the use of opioids versus over-the-counter medications for treating pain associated with hand and wrist fractures.

A third study brings to light the day-to-day hope her work offers by teaming with firefighters and examining how the equipment they wear on the job impacts their bodies.

“Firefighters approached me on this saying they had these issues with musculoskeletal problems and could I help them out,” MacDermid said.

“I’m breaking that down and seeing if there are safer ways for them to do (tasks). Or, possibly, use it to educate other firefighters that there are better ways to do certain tasks. As a rehab person, we’re thinking what’s keeping this person from returning to work and, while a musculoskeletal injury might be part of it, they may also have some psycho-social barriers affecting that as well.”

MacDermid said her work, like most researchers, gains answers along the way, it continues to raise more questions around musculoskeletal injury, solidifying the need for ongoing research.

“Whenever I do modelling, around 25-30 per cent of the problem can be explained based on the injury and the age of the person. But that means for 75 per cent we don’t know why. There are so many variations in people with the same injures, and they have very different outcomes,” she said.

“If you want to improve those outcomes, you have to learn how to reduce those variations. Everything becomes interrelated at some point. The more you are doing, then more you develop those connections between things.”