Chronic pain study seeks farmers to examine treatment barriers

A 2020 paper by the Australian Institute of Health and Welfare (AIHW) said 1.6 million Australians over the age of 45 experienced chronic pain - approximately one in five. The condition was even more common among older Australians, and women.

The impacts are devastating from both a personal, and economic perspective. Sufferers often say they are unable to perform basic work, or social tasks without significant pain, resulting in lost earnings, reduced social activity, and second order affects like depression, or opiate dependency.

AIHW estimated the total economic loss from chronic pain to be $139 billion in 2018.

The broader challenge of accessing health services in the bush make this a challenge in rural, regional, and remote areas. This is even more pronounced in farmers, who often obtain minor injuries from the rough and tumble of farm work.

NSW Farmers Association Wagga Branch Chair Alan Brown suffers from back and neck pain. He said he knows a lot of other farmers who do too - but they don't want to talk about it.

"The average age of farmers is creeping up, so part of it comes with the years," he said.

"When I talk to my peers ... most of them have suffered some sort of injury.

"They get hit by cows, they get hit by sheep, they fall off tractors, all sorts of problems that just come with time and exposure."

UNISA Associate Professor of Rural Health Kate Gunn said long-term affects are exacerbated among farmers due to a 'she'll be right' attitude that makes them more likely to suffer in silence.

"Something we've heard anecdotally a lot is there are a lot of farmers out there nursing various injuries which lead to chronic pain," she said.

"Our previous research has shown farmers often face a lot of barriers to accessing health services, and those often relate to structural barriers - services not being available, not having choice.

"Farmers also have a attitudinal barriers - they like to manage things themselves, and a third type of barrier, which is that farm work is never all done, and the farm tends to come first."

Dr Gunn said this study would be a deeper dive into the reasons farmers have trouble accessing treatment for chronic pain in an attempt to guide public health policy towards creating better outcomes in the regions.

She has already begun work with the National Farmers Federation on a national industry based approach to improving farmers' wellbeing.

"As soon as the message [about wellbeing] come from someone with blue hair in the city, farmers will just turn off, and say, 'well that's not me'," she said.

"We need to ensure messages come from people that they can identify with.

"I think the message we need to send to farmers is that stoicism and being independent is not all bad, but when it comes to your mental health and physical health, it's a bit of a different story."

Mr Brown said he primarily deals with his pain through trying to strengthen parts of his body that prevent it from worsening.

"Right at this moment, I'm walking - I try to exercise regularly," he said.

"I look for labour saving devices, easier ways of doing things to minimise the chance of being hurt."

The first part of the study - due to be released soon - examined the prevalence of chronic pain issues among farming communities.

Now, Dr Gunn and the project's other researchers - PhD student Indika Koralegedera and Dr Gemma Skaczkowski - are seeking farmers to confidentially discuss their own chronic pain.

"We're looking to recruit farmers from around Australia who have experienced persistent pain," she said.

"What we mean by that is pain on most days of the week over the last 12 months, to get an understanding of what that means to them, and most importantly how we can ensure we present evidence based strategies to them in a way they will find acceptable."

Mr Brown said the progress that's been made over the past decade getting farmers to talk about mental health shows progress is possible. In the meantime, the best thing farmers can do is try to stay physically fit.

"Years ago, nobody talked about mental health, but because it's been a conversation point for a number of years now, it's increasingly common for people to be upfront with mental health issues," he said.

"In the same way, if you can start a conversation about chronic pain, people could become quite open about it, and that's a good thing.

"It's easy to say my back hurts, rather than get out and do something that's going to improve your back like targeted exercise."

Mr Brown said farmers should consider engaging with programs like Active Farmers to better stay job fit.

Farmers interested in taking part in the chronic pain study can contact Dr Gunn at Kate.Gunn@unisa.edu.au.