The University of Newcastle, Australia

Backs to the future

Dr Chris Williams is an HMRI Postdoctoral Research Fellow working with Hunter New England Population Health and the University of Newcastle's School of Medicine and Public Health in the field of musculoskeletal pain.

Very easily, though, the former Singleton High School student could have been Chris Williams, builder. In one of life's "sliding doors" moments he relinquished a carpentry apprenticeship, enrolled at Newcastle TAFE and gained entry to University.

Playing rugby union for the Newcastle Wildfires led serendipitously to a sports scholarship at Sydney University. There, he initially completed a Bachelor of Exercise and Sport Science.

With a keen interest in sports injury Chris progressed to a Master of Physiotherapy and also undertook postgraduate training in biostatistics. He finally gained his PhD in 2013 at The George Institute for Global Health and returned to the Hunter that year with his wife and two young children.

Construction's loss is definitely medicine's gain, for the 33-year-old has instead built a pre-eminent research reputation in health promotion and the prevention of musculoskeletal conditions.

His curiosity for research was piqued by his clinical expertise in physiotherapy: "I moved into the public health sphere after realising the enormity of musculoskeletal problems – around 90 per cent of the population will experience back pain during their life.

"Through my physiotherapy practice I knew that we really don't have the answers, so researching this area was greatly needed."

For his doctoral thesis Chris began a major randomised trial investigating the effects of paracetamol on alleviating acute low back pain. His results, published in The Lancet this year, surprised not only Chris but the medical world as a whole.

"Current guidelines for treating acute low back pain recommend paracetamol as the first line medication but there was very little evidence for this," Chris said. "Our research showed that patient recovery time and pain sensation were no different between those who took paracetamol and those who took a placebo.

"It suggested that we perhaps rely on pharmaceutical therapies more than we need to. General lifestyle factors and a positive attitude seem to be the key, including being active, having a good diet and making sure you don't gain weight.

"The sad thing is that most people don't get good advice. If there's one message I could impart, it's that it is critical to remain active and not let pain get on top of you."

In collaboration with Hunter New England Population Health, Chris is primarily focused on improving service delivery of preventative health practices in clinical and community settings. His work relates to the interaction between musculoskeletal management and health risk behaviours like obesity, inactivity, poor diet, alcohol misuse and smoking.

Where chronic diseases are often treated in isolation, Chris believes they could be tackled in unison with back pain and osteoarthritis for example.

"We have ever-increasing waiting lists for hip and knee replacements and we have to look at ways to overcome these problems," he said.

His current involvement in an Osteoarthritis Optimisation initiative at the John Hunter Hospital is contributing to an evidence-based screening service, ensuring patients are referred to the right care at the right time.

In collaboration with NPS MedicineWise, Chris also led the development of an electronic decision-support tool to aid patients and clinicians in managing low back pain. It was rolled-out nationally, attracting over 6000 users in the first six months.

It's a significantly different 'tool' to the ones he could have been wielding. "Research wasn't something I'd have ever considered when I was at school," he said, "but when you find something you really enjoy doing it certainly makes it a lot easier."