Biopsychosocial Mechanisms of Chronic Pain Recovery and Maintenance

Many military Service members, Veterans, and their family members have chronic pain. People with chronic pain are more likely to use opioids and have mental health conditions like depression. Chronic pain may also lead to early military separation and lower quality of life. Because opioids have many negative side effects and raise the risk of death, it is important to take a step back and look at how people recover from chronic pain. Though many studies show how people develop chronic pain, a lot less is known about how people recover from it. To improve chronic pain management, the goal of this study is to understand how emotional, social, and biological factors predict who recovers from chronic pain and who does not.

For this study, we will use survey data, data from the medical record, blood samples, and saliva samples from people who take part in the Pain Biobank study. People taking part in the Pain Biobank are recruited from military clinics like the lab at Walter Reed National Military Medical Center and the Interdisciplinary Pain Management Center at Madigan Army Medical Center. The Pain Biobank collects all this information and samples so that other researchers can use it for their own studies. The Pain Biobank gives us the information and samples in a way that protects privacy, so that we cannot know who these people are. Once we get the data and the samples, we divide people into three groups, those (1) with chronic pain but get better, (2) with chronic pain and do not get better, and (3) without chronic pain. We will run tests to see if the groups have differences in their emotions (like anger, depression, and anxiety), behaviors or physical symptoms (like sleep, fatigue, and alcohol use), social life, or biomarkers. Biomarkers are small proteins and hormones found in blood and saliva. Biomarkers are like traffic lights and tell the body when to start or stop making things after something happens, like getting injured.

There are many benefits of this research. First, it is important to understand what other symptoms and behaviors can predict chronic pain recovery. This information helps care teams tailor treatment or even add new treatments that target these symptoms and behaviors. Second, past research shows that identifying biomarkers can really help us understand what exactly the body is doing, on a very microscopic level. Biomarkers can be used to tell who has a health condition or what the best treatment is to treat a health condition. A few newer studies were able to develop new medication therapies based on what biomarkers they found. If we find biomarkers that predict who gets better, then we can share this information with other researchers who may develop new pain medications that have less side effects, are not addictive, and are more effective. Overall, this may improve pain-related care and chronic pain outcomes in military Service members, Veterans, and their family members.