Pain is a normal and very functional symptom that warns us from potential threats. While the majority of patients recover quickly, a significant part of the population world wide becomes ill and develops a chronic pain condition, with severe impact for patients on quality of life and daily functioning and major costs for the society. This is why we study acute pain, the transition of acute pain into chronic states and chronic pain in patients.

Low Back Pain, fibromyalgia and endometriosis are hidden disorders in our society. Invisible complaints that have a high impact on quality of life and functioning of patients. It also leads to tremendous economic burden. Our fields of research interests, amongst others, concern:

  • Clinical evidence from cohorts in real world
  • Low Back and Neck Pain
  • Fibromyalgia
  • Endometriosis
  • The influence of central sensitisation on pain
  • Pain measuring instruments
  • Prevention of chronic pain
Relevance

How our research benefits to society

Our group contains different research projects

  • In the PRINCE study we are researching the effect of two kinds of pain medication on pain and central sensitization in patients with endometrioses. We follow the patients during two treatment periods in each treatment period one of the pain medications will be used. At the beginning and the end of each treatment period we perform measurements on pain and central sensitization. We are looking into the effect of the medication.

  • The Groningen Spine Cohort is a multidisciplinary cohort of patients with low back pain. In analogy to Lifelines, we follow this cohort of over 1600 patients for 10 years. We have identified patterns of subgroups of patients with low back pain that respond to therapy in differing ways. After 10 years, we hope to get more insight in the health status, quality of life and additional, in costs related to low back pain. 

  • In the CLaSSICO study we aim to determine the effect of segmental nerve root blocks on pain and central sensitization in patients with chronic low back pain with radiation to one leg. Before each treatment and 4 weeks after the last treatment measures will be performed to assess pain and central sensitization. We are looking into the effect of this treatment in this patient group.

     

  • The aim of the DIAMOND study (DIAgnostic segMental blOcks iN vulvoDynia) is to get a better insight in the diagnostic value and involvement of sacral segmental nerve interventions in patients suffering from vulvodynia. Vulvodynia is defined as a chronic vulvar pain non-associated with infectious, inflammatory, neoplastic or hormonal disorders. It is a chronic disease with high impact on patients’ quality of life, (sexual) functioning and on society with a considerable financial burden.
    This study will be conducted in close collaboration with the department of gynecology (UMCG).
    Once the involved sacral nerve(s) have been identified, we will be able to investigate the effectiveness of pulsed radiofrequency of the involved sacral nerves in following studies. This study aims to contribute to a more effective treatment in patients suffering from vulvodynia.

  • Pain in patients with cancer in the palliative phase is a frequent problem. Sometimes the pain in these patients is so severe, or there are many side effects from pain medications that this has a serious impact on their quality of life. With my research to the cordotomy pain treatment, I hope to contribute to the treatment of cancer pain.

  • My research is an overlap of the fields of cannabinoid-based medicines (CBM), pain and dermatology. I have been studying the rare genetic blistering skin condition, epidermolysis bullosa, and the impact of CBMs on severe pain and itch in patients with this condition. Having highlighted several case-series and cross-sectional studies on the use of CBM, I have ongoing investigations at the cellular level as well as in the form of a clinical trial to be completed in 2022. The lead investigators in my research are Prof. dr. André Wolff (Anaesthesiology Pain Center), and Dr. Marieke Bolling (Dermatology)

  • In many elderly, the effect of regular pain interventions are less or not able to provide because of comorbidities or polypharmacy, limiting the ability to move or exercise, or to take medication as would be the first choice. In this study, we aimed to gain insight in the effect of music and abdominal vibration to elicit vagal nerve activation, and hence, to decrease pain without side effects. Together with an international group from Italy and Denmark, we concluded that vibration and music did not change the perception of pain in the elderly. The results of the study can be found here.

  • Disability due to cervical radiculopathy has a significant impact on the patient’s quality of life, particularly because most patients participate in the community’s labour force. Cervical radiculopathy due to discogenic or spondylotic stenosis of the neuroforamen can be surgically treated by an anterior discectomy with fusion (ACDF) or a posterior foraminotomy (FOR). Currently, there are no evidence-based guidelines on the most appropriate surgical treatment strategy. In the Netherlands, there is a surgeon’s preference for ACDF. However, there is evidence that FOR is as effective as ACDF, has a smaller complication rate and is less expensive. The study objectives of the FACET study are to compare clinical outcome (decrease of radiculopathy in VAS ARM pain and Odom's criteria), complication rates, cost-effectiveness and work absenteeism with a non-inferiority hypothesis of FOR to ACDF.
     

  • In the initial referral process for patients with (chronic) low back pain (LBP), patients are currently asked to fill out various questionnaires. Based on these responses, physician assistants aim to triage patients to the most optimal treatment modality, including surgery, orthopedics, rehabilitation or pain anaesthesiology, or to provide the patient with advise and possible referral to primary care (e.g. physiotherapy). This process is based on best practice and there appears a substantial variation  in triaging between physician. The aim of this study is to make the triaging process more evidence based by creating a data driven machine learning clinical decision support tool to 1): identify what treatment works for which patients and 2) create a decision support tool to help physician assistants in their triaging process. This study is being conducted in close collaboration with the University of Oldenburg in Germany. Results will be expected in 2022.

  • DANI-study: Nociception measurement and management is a quality indicator for hospitals. Monitoring of nociception in the operating room could result in improved patient safety, higher operating room throughput, and better patient outcome. In current clinical practice, anesthesiologists primarily rely on changes in heart rate and arterial blood pressure as a measure of the balance between nociception and anti-nociception (i.e. the dose of analgesic drugs) during surgery. The aim of this pilot study is to collect data of different measurements such as vital signs, brain activity and facial expressions to perform a retrospective analysis using a single measure or a  combination of measures. Measurements are obtained in a research setting from healthy participants while they experience thermal and electrical stimulation.

Contact

Remko Soer Post doc researcher, physiotherapist, human movement scientist

University Medical Center Groningen (UMCG)
Department of Anesthesiology
PO Box 30.001
9700 RB Groningen
The Netherlands

Visiting address
University Medical Center Groningen (UMCG)
Department of Anesthesiology
Hanzeplein 1
9713 GZ Groningen