Pain management focus of Chair

Dr. Patricia Morley-Forster has been appointed the Earl Russell Chair in Pain Management at Western. She will also act as Medical Director of the Interdisciplinary Pain Program in Western's Faculty of Medicine & Dentistry and St. Joseph's Health Care London.

According to a recent survey by Janssen Ortho Inc., 29 per cent, or about 9 million Canadians, suffer from chronic pain, defined as pain lasting more than six months.

Pain management involves diagnosing the original source of the pain such as nerve injury, muscular or arthritic pain, and setting out a treatment plan that may include medications, physiotherapy, nerve blocks or changes in work environment. Accompanying sleep problems, anxiety and depression are also treated and often, psychologists become involved to teach coping strategies to the individual.

Through her research, Morley-Forster hopes to determine what factors predict transformation of acute pain into chronic pain and whether physicians can intervene at an earlier stage to prevent chronicity. Currently, she is setting up a research team that will follow patients with acute neck or lower back injuries for five years to determine predictors of chronicity.

Morley-Forster will work to increase the number of clinics at the Pain Management Centre at St. Joseph's Hospital during her tenure. With the increase in clinics she hopes to shorten waiting lists for those in the community needing to see a pain management specialist.

"An aging population means more people will be suffering from chronic pain. The good news is we are now in a position to start closing the gap between the tremendous explosion of basic science knowledge of the mechanisms of pain and management of clinical problems," says Morley-Forster. "Education of family physicians in the management of chronic pain must continue to be a high priority in Canada."

Morley-Forster received her BSc in Biology from Western and her M.D. from the University of Toronto. After interning at the Ottawa Civic Hospital and doing an anesthesia residency at the University of Toronto, she worked as an anesthesiologist at St. Joseph's for 14 years. She then took a sabbatical to conduct cancer pain training at the London Regional Cancer Centre, followed by a chronic non-cancer pain fellowship at the Wasser Pain Management Centre at Mount Sinai Hospital in Toronto. A brother who suffered severe pain from cancer, and ultimately died of it, gave her personal insight into how effective treatment for pain could make a difference in the quality of life.

"I spent many years treating post-operative pain and providing epidurals to women in labour and became interested in the tremendous variation of patients' responses to pain," says Morley-Forster.

"I was interested in the advances of research in the 1980s and 90s that showed pain signals could be blocked or enhanced at different levels in the central nervous system."

Dr. Carol Herbert, Dean of Western's Faculty of Medicine & Dentistry says, "Many Western faculty members are internationally recognized for pain research from bench to bedside. The Earl Russell Chair provides the vehicle for us to bring together those with expertise in pain research and management to build knowledge and improve treatment for patients. We are delighted Dr. Morley-Forster has taken up the challenge, turning her energy and skills to developing both training for practitioners and integrated research initiatives."

The generosity of Dr. Earl Russell, Western professor emeritus and alumnus (MD '50), established the Chair. His interest in pain management began as a young doctor serving in the Royal Canadian Army Medical Corps during the Korean War. He worked in the post-operative ward of the 8055th Mobile Army Surgical Hospital - the same unit from which thoracic surgeon and author Richard Hooker took his inspiration to write his famous novel, MASH.

Today, Dr. Russell, age 82, devotes three days a week to providing pain relief for some 80 patients per week who visit him at two busy rural clinics in Ingersoll and Newbury, Ontario.