Chronic pain is variously defined as a pain syndrome lasting longer than three-to-six months and can involve any organ system. Chronic pain is associated with severely diminished quality of life, reduced work productivity, greater disability, and increased risk for dependency on opioid and other medications commonly used for treating pain. It is estimated that roughly 100 million adult Americans suffer from chronic pain, a number which only stands to increase due to an aging population and increasing chronic disease.
Estimates of direct U.S. healthcare costs associated with treating chronic pain exceed $250 billion annually. The societal burden of disability and reduced social functioning add substantially to the economic consequences. Despite the enormous public health burden of chronic pain, current treatment approaches are often insufficient, leaving millions of patients with only limited options to relieve their suffering.
Prescription opioids are the most common medication used to treat pain, and their use has increased dramatically in recent years. However, long-term use of prescription opioids remains controversial, and the evidence supporting long-term use of opioids for pain and functional outcomes is mixed. There is considerable concern over increased risks associated with prescription opioids such as opioid abuse, falls, overdose and deaths. Our researchers have found that substance use and depression are associated with long-term use, which put patients at risk for these adverse events. Researchers study trends in prescription opioid use over time, as well as behavioral interventions in primary care to help patients self-manage their pain.
We are taking a multi-faceted approach to the problem of chronic pain and the consequences of its treatment. Currently, our investigators are conducting clinical studies of diverse treatments for common musculoskeletal pain conditions such as chronic low-back pain, acute sciatica, osteoarthritis ("degenerative arthritis"), gout, and tendon disorders, as well as neurologic disorders such as migraine headache and peripheral neuropathy. Treatment options under investigation include both conventional medical interventions as well as complementary and alternative approaches. To date, our researchers have conducted studies of acupuncture for patients with low-back pain, oral steroids for acute sciatica, epidural steroid injections for lumbar spinal stenosis, management strategies for preventing gout flares, as well as observational studies of back pain in older patients and the genetics of migraine headache.