Concept: High-Priority Pain Research

Project Concept Review

Council Date: January 21, 2022

Program Director: D. Craig Hopp, Ph.D.

Background

Pain is the condition for which adults in the United States most often use complementary and integrative health approaches. Under normal circumstances, pain is an important physiological response that serves as a warning of actual or potential tissue damage. Very severe acute and/or chronic persistent pain can indicate ongoing tissue damage, such as inflammation, or can develop due to central nervous system sensitization resulting from increased neuronal and circuit activation in nociceptive pathways even after the tissue has healed. These pathological pain types adversely affect function and psychological and social well-being. Pain is most often treated with pharmacologic and/or surgical interventions. However, these treatments are often associated with adverse outcomes, including tissue damage following surgery and harmful side effects associated with pharmacologic treatment, such as risk of misuse and addiction, particularly in the case of treatment with opioids. Complementary and integrative health approaches to pain management may offer safe, effective, and cost-efficient options without the liabilities of existing pharmacologic and surgical treatments.

Research evaluating the impact of complementary and integrative approaches on pain remains a priority for the National Center for Complementary and Integrative Health (NCCIH). In addition, a deeper understanding of the mechanisms by which complementary approaches exert their effects and identification of therapeutic biomarkers provide a foundation that will allow treatments to be optimized to predict those individuals or groups most likely to respond to specific treatments. For interventions to be integrated into clinical care, rigorous clinical trials are needed to assess the feasibility and then the efficacy of the intervention. Finally, implementation research is needed to understand how the intervention can become an integral component of clinical care.

Purpose of Proposed Initiative

On October 26, 2017, the Acting Secretary of Health and Human Services declared a nationwide public health emergency stemming from the ongoing opioid crisis. The declaration has subsequently been renewed multiple times, most recently in October 2021. In response to this public health emergency, NCCIH wishes to issue a funding opportunity announcement (FOA) to promote innovative pain management research leveraging nonaddictive complementary and integrative health approaches. The topics covered by this FOA will focus on high-priority areas for NCCIH, including complementary health approaches with psychological, physical, and/or nutritional inputs; basic to mechanistic to clinical study designs; and a range of pain conditions.

Objectives

This FOA will aim to promote pain studies in the following research areas:

1. Basic/mechanistic, translational, or clinical research on pain related to sickle cell disease
2. Basic and mechanistic understanding of myofascial pain
3. Fundamental science of biophysical force-based interventions to prevent or manage chronic pain 
4. Studies identifying novel therapeutic targets of pain for nonaddictive natural products
5. The science of music-based interventions to enhance pain management
6. Multicomponent pain management intervention development
7. Trials of complementary and integrative interventions delivered remotely or via mHealth