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How to get started with pain research?! A story from Nepal

Today's blog is from Saurab Sharma. Saurab is a PhD candidate at University of Otago, New Zealand studying musculoskeletal pain. He is also an Assistant Professor at Department of Physiotherapy at Kathmandu University School of Medical Sciences (KUSMS), Nepal. He teaches physiotherapy assessment and management of musculoskeletal conditions, evidence based practice, and research to undergraduate physiotherapy students. After his PhD, he aspires to start a pain research centre at KUSMS, and conduct high quality pain research, and train students. He is also the editor of the blog www.linkphysio.com to disseminate contemporary knowledge in physiotherapy.

Starting pain research in Nepal was difficult. I encountered several challenges at the start. In this blogpost, I will highlight the challenges, and some ways I overcame these challenges.

Challenges

The first challenge was the lack of full-time pain researchers or a colleague who was as passionate about research as I was. For this reason, I was lacking a mentor who could help me through the research journey. Second, high quality (pain) research was rare in Nepal, which links to first challenge. This was partly due to the limited availability of validated outcome measures related to the assessment of pain and related problems. Third, we had limited resources and funding opportunities for pain-related research. Finally, the need to catch up with contemporary knowledge in the area of pain science was another weakness, which I needed to address in ongoing basis.

Strategies I used to overcome the challenges

To overcome my weakness of limited knowledge in pain, I invested a lot of time in updating my knowledge. I made a habit of reading 2-3 high impact articles in pain research every day, mostly during my commutes. Also, to become updated in the pain field, I followed world leaders in pain research via social media (mostly Twitter), started reading their posts, and managed to get up-to-speed with the status-quo. Similarly, I also listened to podcasts, attended webinars from these experts. I made that an every-day habit.

My prior knowledge of evidence-based practice helped me critically appraise the articles, presentations, and podcasts. As a result, I was able to appraise them against basic principles of evidence-based practice. Doing so helped me filter the mass information that is now available online. Finally, I invested both time and money to attend relevant conferences and courses which helped me gain contemporary knowledge in pain science.

Meanwhile, to find a mentor who would guide me through the pain-research journey, and who could also make this journey fun (or at least less painful), I made calls for collaboration via social media platforms (such as ResearchGate). I didn’t have great expectations, but to my surprise, two world leading pain scientists responded with positive messages. Reflecting back, this was a career changing moment. I embraced the opportunity, and both of them are now my PhD mentors. We then discussed the challenges of conducting pain research from Nepal and converted some of them to opportunities.

My research journey

My collaborators and I identified key outcome measures used in pain research; for example those recommended by core outcome sets for pain research (low back pain and chronic musculoskeletal pain - my interest areas). I then embarked on a project to cross-culturally adapt core outcome measures into Nepali with all my available resources (friends, students, and other professional translators), and continued with the validation of these measures.

I also applied for a collaborative research grant with Prof. Mark Jensen to continue pain research in Nepal. We planned to explore the role of culture in pain-related factors, with the main objective to develop several outcome measures to assess pain and related domains in individuals with chronic pain in Nepali. We were successful and this work has become the foundation of my research career. This collaboration and grant success also helped me secure PhD funding at the University of Otago to continue this line of research with Prof. Haxby Abbott.

My advice to those who wants to pursue a research career

  1. Invest time in analysing your career interest, strengths, weaknesses, challenges, and opportunities.

  2. Invest some hours every day in updating knowledge in your field.

  3. Know that there are people who always want to help people living in resource limited settings. You are not alone. Always, ask for help, and work with someone who knows the field better than you. In other words, collaborate!!!

  4. Surround yourself with people who are experts in the field, may it be in real life or virtual life (social media).

  5. Work to improve your track record. This could be attending courses, conferences, presenting papers at conferences, applying for awards/ grants/ scholarships. One success will lead to another.

  6. Start working on your research projects with your potential supervisor before starting a PhD, which can make PhD journey easier, as you know if he/she is the person whom you want to work with for the next three or more years.


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