Making pain social: developing a critical social science of pain

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An Integrated Understanding of Chronic Pain

Basic and strategic research for infectious disease control at the interface of the life, health and social sciences

It is an exciting time for pain research at the Department of Veterans Affairs (VA). In the seven years that I have been a Scientific Program Manager in the Rehabilitation Research and Development Service in the Office of Research and Development (ORD), I have witnessed an increase in the number of projects and funded investigators within VA's pain portfolio. In 2009, there were approximately 57 projects on pain research. In July 2015, the number of projects was 109, and importantly, the investment in pain research almost tripled within this time span. This change can be attributed the increased interest in pain research within VA's scientific and clinical communities brought about by the unique chronic pain management needs of Veterans returning from Iraq and Afghanistan and the collaborative effort between VA's pain research community and ORD spotlight pain research. Pain research in ORD appropriately spans the translational research spectrum and includes basic/foundational research mainly in animal models, epidemiology determine the distribution of various painful conditions in the VA, pain diagnosis, management and treatment of pain, underlying causes of chronic pain including the transition from the acute chronic state, adverse events associated with pain management, and health services-level research. This editorial covers a fraction of the innovative and unique areas of pain research being conducted at the VA and the important role VA researchers play in the pain community, as evidenced by VA participation in the Interagency Pain Research Coordinating Committee (IPRCC) National Pain Strategy (NPS). * Pain management: The challenge of treating Veterans with chronic pain and coexisting conditions has sparked an interest in how care for these individuals effectively. Team-based integrative approaches play up VA's strengths as a healthcare system and include the clinicians who see Veterans in the clinic, who also conduct basic up health services research. This is reflected in the high number of treatment-related projects (n = 46) examining the effectiveness of exercise and activity; complementary approaches, including electroceuticals (e.g., transcranial magnetic stimulation) and yoga; and testing different formulations of drug therapies focused not only on pain but also on coexisting conditions, including posttraumatic stress disorder (PTSD), depression, sleep, and substance use disorders. The emphasis of treatment includes reduced dependence on opioids as go to drugs and examining alternate forms of pain management, putting the Veteran in the driver's seat in managing the painful condition. * Comparative-effectiveness research: Comparative-effectiveness studies emphasize the importance of and results and are reality checks as what treatments should be effective and what treatments actually are effective. These types of studies are unique healthcare systems and aim improve the delivery of care and maximize patient satisfaction while being cost-effective. It is an area of research well-suited the VA and an area in which the VA Health Services researchers are leaders in the field. Results from these studies change the way care is delivered at the VA. An example of evidence-based practice research is the adoption of acupuncture for chronic low back pain at the VA, while an example of practice-based evidence research is the ongoing assessment of the Stepped Care Model for pain management. In this case, results recommend the rearrangement of steps make the process more efficient and effective, including rotating the clinicians versus having the patient rotate through the steps. Comparative-effectiveness studies are an ideal way determine best practices that benefit the Veteran. * Precision medicine: Everyone is talking about precision medicine, but VA pain researchers and clinicians are actually walking the walk. …

Beyond the needle: expanding the role of anesthesiologists in the management of chronic non-malignant pain.

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forms of analgesic therapy without any promotion for specific indications, as well as classes of drugs, such as COX-2 inhibitors. Dr.

Predictors of Male Sexual Dysfunction in Urologic Chronic Pelvic Pain Syndrome (UCPPS), Other Chronic Pain Syndromes, and Healthy Controls in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network

Neuropathic pain needs systematic classification

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Systematic review of autistic representation in the treatment literature for pediatric chronic pain.

Exercise as a Treatment for Chronic Pain

Pain catastrophizing has emerged as a highly important construct in pain research. The Pain Catastrophizing Scale (PCS) is a widely used self-report measure used to determine a person's level of pain catastrophizing, assumed to be associated with an ongoing, recalled or anticipated pain experience. In practice, instructions for self-reporting catastrophizing typically do not provide a specific pain referent, even when assessing patients with chronic pain. Researchers have noted that it is not known what type of pain participants are referring to when responding to a catastrophizing questionnaire. In the current study, 182 presumably healthy undergraduate students completed the PCS followed by a query regarding the pain referent used to complete the scale. In addition, they were asked if they have ever experienced chronic pain and to list their worst pain experience. The most commonly used primary referents included pain due to acute injury (26.4%), headache (18.0%) and general physical pain (11.5%). The type of primary referent and the number of referents did not influence the catastrophizing scores. However, the catastrophizing scores were influenced by the context of the primary pain referent, i.e., whether the primary pain referent was non-chronic worst pain, both chronic and worst pain, chronic pain or unrelated to either chronic or worst pain. Notably, a larger than expected proportion of participants reported having experienced chronic pain (44.5%; n = 81). The examination of pain referents while responding to a catastrophizing measure would add to our understanding of a person's pain experience and related catastrophic cognitions.

Chronic pain and narcotics: a dilemma for primary care.