NIH HEAL initiative helps chronic pain sufferers

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Living with pain is debilitating and frustrating. If the cause of chronic pain is unknown, it can be a lifelong struggle to find appropriate treatment and relief. 

George Mason Bioengineering professor Siddhartha Sikdar saw his mother-in-law struggle with chronic pain, as well as several students, friends, and colleagues.   

“When patients are not able to get an appropriate diagnosis and effective treatment for pain, the reliance on using opioids may be greater,” says Sikdar. “The Helping to End Addiction Long-Term (HEAL) initiative is seeking ways to address pain without opioid intervention.”

Sikdar and several colleagues from CASBBI received funding from the National Institutes of Health (NIH) HEAL initiative to study chronic myofascial pain. This type of pain originates from muscles and/or associated soft tissues, and is an important yet poorly understood area. In a two-part study, the team will first develop biomarkers to study the association between muscle tissue abnormality and pain, and then conduct clinical trials to test two different interventions. 

“Chronic pain has a profound impact on life,” says Sikdar who is director of the Center for Adaptive Systems of Brain-Body Interactions (CASBBI). “It can affect mood, sleep, concentration and is often associated with anxiety and depression.”

Identifying the cause of chronic pain is often difficult and complex. According to Sikdar, it can involve many factors including stress, psychosocial factors, and long-term changes in the nervous system. 

Currently, the mechanisms of pain related to injury, the skeletal system, or the nervous system are well understood, but the role of muscle tissue in pain remains enigmatic. According to Sikdar, one theory is that inflammation builds up over time in muscles and associated connective tissue and manifests as pain which doesn’t get better or go away on its own. 

The first part of the initiative will involve the use of cutting-edge ultrasound imaging techniques as one of the primary methods to try to find out what happens in the muscles of chronic pain sufferers. 

One of the treatments Sikdar and his team will evaluate during the clinical trial phase is dry needling, where a very thin needle is inserted into the skin to treat muscle tissue. Another treatment will inject an enzyme into muscle tissue to improve the gliding between layers of connective tissue. The goal is to identify what kinds of treatments work best for each individual suffering from chronic myofascial pain.

Twenty-five million Americans live with daily chronic pain and lack effective and safe non-opioid options for pain management. The NIH launched the HEAL Initiative® to provide scientific solutions to the opioid crisis and offer new hope for individuals, families, and communities affected by this devastating crisis.