NIH grant will fund non-pharmacological pain research

More than 100 million Americans suffer from chronic pain – outnumbering those affected by heart disease, diabetes and cancer combined.

To develop innovative approaches to pain management, a team of behavioral and social science researchers on Cornell’s Ithaca campus, clinical researchers at Weill Cornell Medicine and computer scientists at Cornell Tech has received a five-year, $3 million grant from the National Institute on Aging, part of the National Institutes of Health (NIH).

The NIH grant is the third received by Cornell’s Translational Research Institute on Pain in Later Life, which focuses on interventions that help people change behaviors contributing to pain.

Finding alternatives to medicine in treating pain has become important in recent years, as commonly administered pain medications are causing harm and contributing to the opioid crisis.

“Pharmacological interventions remain the first choice of many providers and patients, but there is limited evidence to guide pain-management decisions, with relatively few treatment studies that include older adults,” said Karl Pillemer, the Hazel E. Reed Professor of Human Development in the College of Human Ecology and co-director on the grant.

“This grant will be the catalyst to bring together a diverse group of social and behavioral scientists and people working in clinical medicine, psychiatry, rehabilitation medicine and technology to create better solutions to the problem of chronic pain, which affects a huge number of older people and causes vast amounts of possibly preventable suffering,” said Pillemer, also a professor of gerontology at Weill Cornell Medicine.

However, relatively few researchers study pain management that goes beyond drug therapies. Untreated pain frequently takes a physical, mental, social and economic toll on older adults and their caregivers, according to the researchers.

Translational research – which builds on basic science to create new therapies – is needed to move promising behavioral pain interventions more quickly into use in clinics, long-term care and people’s homes, said investigators. The institute, designated as a National Institute on Aging-funded Edward R. Roybal Center that focuses on chronic pain, will develop and test such programs to determine their real-world effectiveness and how best to enhance their effectiveness and reach.

New research will have a special focus on behavioral treatments in underrepresented populations, including people with cognitive impairment, residents of rural areas, minorities, and those aging with HIV, all of whom are disproportionately affected by pain.

“We will focus on approaches based on the biopsychosocial model, which recognizes that pain has physical, psychological and social components,” Pillemer said.

Specific therapies may include relaxation training, cognitive-behavioral therapy and mindfulness meditation, he said. This also includes looking at communication tools, such as social media and smartphones, to promote behavior change that could lead to better pain management.

“Another behavior change is physical exercise,” Pillemer said. “A paradox of pain is that exercise helps reduce it, but it’s difficult for people in pain to think about exercising. So they don’t exercise, they get more sedentary and the pain increases; it’s a vicious circle. So how do you get people to actually change their behavior?”

The grant’s co-directors are Cary Reid, the Irving Sherwood Wright Associate Professor in Geriatrics at Weill Cornell Medicine, and Elaine Wethington, professor emeritus of human development and of sociology. In addition to the Cornell-affiliated researchers and scientists, other partners include elder-service providers.

One key partner is LiveOn New York, an umbrella organization representing many of New York City’s senior centers.

“Working with the Cornell translational research institute greatly benefits community organizations in New York City,” said Allison Nickerson, executive director of LiveOn. “Our senior centers and other agencies continually encounter elders struggling with chronic pain, and solutions are in short supply. By focusing on developing programs to manage pain that can be implemented in the community, this institute helps us help our clients.”

“The involvement of community partners in every aspect of our research is crucial to the success of the studies,” said Reid, who is also an associate professor of medicine at Weill Cornell Medicine. “Our goal is to use research to directly improve the lives of older people, and working hand-in-hand with those who serve them helps make this happen.”

Stephen D’Angelo is assistant director of communications in the College of Human Ecology.

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