Pain Management, Opioid Safety, and PDMP (PMOP)
VA RESEARCH FOR VETERANS - Pain Research Overview
Pain Management Research
VA researchers are working to develop new approaches to alleviate Veterans’ pain, which may result from spinal cord injury, burns, amputations, traumatic brain injury, cancer, or musculoskeletal conditions. There are many types of research being conducted within VA, including studies of medications, pain treatments, and self-management of pain. Below are some major areas being studied to help Veterans manage their pain:
Complementary and Integrative Medicine
Complementary and integrative health therapies can be used along with other pain treatments, and sometimes can even replace them. They include techniques like tai chi, yoga, meditation, and acupuncture. In 2016, Congress passed the Comprehensive Addiction and Recovery Act, which mandates that complementary and integrative health therapies be provided in VA to provide non-medication options to treat pain and pain’s related health conditions. VA researchers are looking at trends in Veterans’ use of these therapies and are generating knowledge about which of these therapies are most effective for pain and other conditions. For more information see: https://www.va.gov/PAINMANAGEMENT/Veteran_Public/Complementary_Treatments.asp
Therapeutic Approaches
CBT for Chronic Pain (CBT-CP) - The gold standard non-pharmacologic treatment for chronic pain is cognitive behavioral therapy (CBT). CBT for chronic pain is an evidence-based treatment that can be delivered in individual or group sessions and includes multiple modules typically administered over 8-12 weeks. Intent-to-treat analysis from the national dissemination of CBT for chronic pain in the VHA revealed significant improvements in Veteran’s reports of pain interference, pain catastrophizing, and quality of life. For more information: https://www.va.gov/PAINMANAGEMENT/CBT_CP/Veterans.asp
Pain Self-Management
Learning skills to help manage your pain is a central goal to CBT for CP; however, you can learn and use these skills on your own right now. Learning self-management skills can be a powerful way to control your pain instead of your pain controlling you. Simple techniques like breathing exercises, movement, stretching, and mindfulness techniques can help you build confidence that you can better manage your pain. The VA has a number of mobile applications and tools to help increase pain self-management. There are a number of ongoing studies that provide a web-based platform for Veterans to learn and develop better self-management strategies for pain. For more information: https://www.va.gov/PAINMANAGEMENT/Veteran_Public/Self_Management.asp
Medical Treatments
There are a number of medical treatments that can help manage pain. The literature on use of prescribed opioids is mixed, but generally suggests that prescribed opioids are not particularly effective at managing pain for the average Veteran. Discussions about use of prescription opioids to manage pain should occur in collaboration with your VA provider. Recent VA/DoD guidelines have advocated for non-pharmacological approaches as a first time treatment for chronic pain. There is some evidence that medications that are safer than opioids may help effectively manage pain in conjunction with non-pharmacological treatment. These medications include non-steroidal anti-inflammatory drugs (like ibuprofen), tramadol, and some anti-seizure or anti-depressant medications. Additionally, injections of medication such as botulinum toxin and cortisone may provide some relief for some painful conditions. For chronic migraines, new drugs called biologics have demonstrated promising results. Similar to opioids, discussions of medication options to manage pain should always be in collaboration with your treatment team.
For specific pain studies information, please review our ongoing and published works see: https://www.research.va.gov/topics/pain.cfm#research
Should I Participate in Research?
Research studies give Veterans the opportunity to contribute their perspective and feedback to VA programs and interventions for pain management. As a Veteran, your assistance can help the VA prevent, detect, or treat pain for both your own and other Veterans’ continued health. Research is at the heart of many important and helpful VA programs for pain management.
One major area of research within the VA is clinical trials; these are research studies on interventions, medications, and other health programs that help researchers determine if new treatments are effective and safe. VA research also often looks at other aspects of pain management as well, such as improving the quality of life for Veterans with specific pain conditions.
If you are interested in more information on research trials, or are hoping to participate in a clinical trial, you can find information on studies actively recruiting Veterans with pain see: https://clinicaltrials.gov/ct2/results?term=veterans&cond=chronic+pain&Search=Apply&recrs=a&age_v=&gndr=&type=&rslt=
Research for Veterans - Resource Topics of Interest
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Literature Alerts for VA Staff
The VA Library Network will provide VA staff an index of recent articles related to opioids and many other areas of interest right to your work mailbox. If you are interested in subscribing to this alert click here.
If you have questions or suggestions for pain-related resources to share, please send an email to VHA Pain Management Webmaster Group. Please do not submit any personal healthcare information. Questions about personal care should be directed to the local VA facility.
Disclaimer: *Links will take you outside of the Department of Veterans Affairs Website. VA does not endorse and is not responsible for the content of the linked websites.
