Strategy for Pain Management

More than 25 million Americans suffer from daily chronic pain. Through the trans-NIH Initiative or in partnership with outside organizations (noted with an asterisk), NIH will support research to understand how chronic pain develops, making patients susceptible to risks associated with opioid use, and will develop a data sharing collaborative, new biomarkers for pain, and a clinical trials network for testing new pain therapies. NIH will also enhance the pipeline of treatments for pain and enhance clinical practice for pain management.

Understanding the Origins of Chronic Pain

Problem: Virtually all individuals experience occasional episodes of acute pain. In some instances, acute pain gives rise to a chronic pain state, accompanied by maladaptive changes throughout the nervous system. It is not known why certain patients develop chronic pain.

Approach: Develop new tools and biomarkers to detect changes in the brain associated with the transition from acute to chronic pain, leveraging innovative new imaging and -omics neurotechnologies, to detect altered brain circuits and/or genes and develop tailored interventions to control pain and restore function:

  • Identify biomarkers that can predict those individuals who are more likely to transition from acute to chronic pain.
  • Use advances from the NIH BRAIN and SPARC initiatives to develop innovative technologies to produce detailed maps of pain circuits, and monitor and modulate pain circuit activity.

New Treatments for Pain

Problem: Opioids do not work for many patients and carry risk of misuse and addiction. New therapies for pain are urgently needed.

Approach: Develop new, effective, and non-addictive approaches for pain management, in partnership with biopharmaceutical companies and the FDA:

  • Establish a standardized platform for validating new drug targets.
  • Facilitate the development of devices to treat pain.
  • Accelerate development of drugs in the pipeline through a data and information sharing collaborative between industry groups, with NIH as a neutral broker.*
    • Identify and validate biomarkers for pain, to predict and track the response to pain treatments and facilitate the testing of new drugs.*
    • Define clinically meaningful outcomes for patients.
  • Test new pain therapies in a new clinical pain research network.*
  • Develop new models or improve current models of integrated pain management.
  • Collect and disseminate evidence on best pain management strategies for multiple different and distinct chronic pain conditions likely to be treated with opioids, such as back pain, osteoarthritis, complex regional pain syndrome, diabetic neuropathy, pain associated with ME/CFS and sickle cell disease, vulvodynia, ocular and other craniofacial pain syndromes and others.

Enhance Clinical Practice in Pain Management

Problem: Different patients with different pain conditions need different treatment strategies. There is no current infrastructure for implementing the best pain management for patients.

Approach: Define and support best practices for pain management:

  • Expand Centers of Excellence in Pain Treatment and Education.
  • Enhance medical and dental education by working with schools, board exam preparation organizations, accreditation entities, CME programs, healthcare systems, practices, hospitals, and clinics.

This page last reviewed on March 12, 2018