Chronic musculoskeletal pain (CMP) – daily pain in the muscles, bones, ligaments, tendons and nerves that lasts for six months or longer – contributes to approximately 21% of worker disability issues in this country and costs $500 billion annually from lost wages, treatment and medications, according to a study conducted by Johns Hopkins University.
In an effort to develop a more effective strategy against this debilitating condition, a team of doctors and researchers at Wake Forest School of Medicine has received a four-year grant of approximately $4 million from the National Institutes of Health.
The funding will support a clinical trial that combines an FDA-approved antidepressant drug with a web-based pain-management program to determine if pain relief can be enhanced, said the study's principal investigator, Dennis Ang, MD, professor of rheumatology at Wake Forest School of Medicine.
"Both of these treatments work pretty well separately, so we hope that combining them will significantly increase pain relief and improve patients' quality of life," Ang said. "In addition, we will work closely with the study participants' primary care doctors during and after the trial to coordinate care that hopefully will be more effective, less expensive and more accessible for patients."
Study participants will participate in a 24-week clinical trial of primary care patients with CMP. In the trial, 280 participants will be randomized to one of three treatments: combination of an antidepressant drug and web-based cognitive behavioral therapy with a health coach; the above combination treatment without a health coach; or drug therapy alone. Cognitive behavioral therapy includes relaxation exercises, guided imagery, lifestyle changes and stress management techniques.
Ang's team hopes that this multi-pronged approach will optimize pain-related treatment outcomes at the primary care level where most pain patients are treated. Using a health coach to encourage patients to keep practicing their pain-coping skills after the trial should increase the likelihood that the proposed intervention has long-term benefits, he said.