Federal advisory group publishes recommendations on prevention of acute, chronic pain

A University of Texas at Arlington professor led a federal advisory group that has published its recommendations on the prevention of acute and chronic pain to the Federal Research Pain Strategy, an interagency committee that oversees the government's long-term strategic plan to support pain research.

Some 100 million Americans suffer from chronic pain at an estimated annual cost of $635 billion in medical interventions and lost productivity, according to the National Academies -linked Institute of Medicine.

"Our main conclusion is that better public education to heighten awareness about pain and its health consequences, and to teach individuals to manage their own pain, would make the greatest short-term impact," said working group leader Robert Gatchel, UTA Distinguished Professor of Psychology, and Nancy P. and John G. Penson Endowed Professor of Clinical Health Psychology.

"It is critical to find new ways to reach out to society at large to discuss pain. We really need to explore the use of technology, social media and social-marketing techniques to address misconceptions about pain and the factors that exacerbate its societal impact," he added.

For many patients, the traditional biomedical model of pain has proved inadequate as it cannot explain differences in pain intensity and disability; the variability in treatment response; the persistence of pain in the absence of detectable physical pathology; or the variability in chronic pain responses for individuals with equivalent physical pathology.

"Our group considers that psychosocial factors such as beliefs, attitudes, prior learning experiences, as well as social, cultural, racial and ethnic group membership, all impact the experience and perceptions of pain, and also affect how care is sought, from whom it is sought, and the entire patient-health care provider relationship," Gatchel explained.

"We have concluded that we need more research to explore the role of these other factors to help formulate more individualized treatment recommendations, and develop a precision medicine focus for pain," he added.

The report also tackled the topic of opioid medications, which were initially developed for acute pain, but are now often prescribed for chronic pain. The group found that evidence indicates that opioids may have only modest or no effects on improving function for individuals with chronic pain recovery, and that their use may negatively impact functional recovery.

"More research is needed to understand the effects of opioids, including studies that evaluate long-term outcomes related to disability and return-to-work," Gatchel explained.

"This research should also compare the effects of opioids to non-opioid active therapies such as exercise, cognitive behavioral therapy, yoga, mindfulness-based stress reduction and non-opioid medications," he concluded.

Gatchel and his working group also published their conclusions this month in the prestigious Journal of Pain as "Research Agenda for the Prevention of Pain and Its Impact: Report of the Work Group on the Prevention of Acute and Chronic Pain of the Federal Pain Research Strategy."

Perry Fuchs, UTA's chair of psychology, congratulated Gatchel on his group's work.

"It is an honor that a UTA faculty member was chosen to lead this federal working group on new research areas to prevent acute and chronic pain," Fuchs said. "This work could really provide new hope for so many patients who currently suffer from pain and pain-related issues."