Issue link: https://viewer.e-digitaledition.com/i/1446582
CHRONIC PAIN AFFECTS millions of people in the United States, leading to a decreased quality of life and mental health problems for ma ny of those a ected. The high percentage of people who tra nsition from acute pa in to chronic pa in following surgery is considered a major factor in the ongoing opioid epidemic. Experts have long been perplexed by what, exactly, leads to the development of chronic pa in in some individua ls — but not others — after acute pain events. Researchers are striving to answer this question in a new study that will identify biomarkers to help understand what causes chronic pain and better predict which patients will experience it after surgery. " There is much about the etiolog y a nd pathogenesis of chronic pain that we do not understand," says Joshua J. Jacobs, MD, Professor and Chair of the Department of Orthopaedic Surgery at Rush University Medical Center. "Delineation of the pathways leading to the transition from acute to chronic pain following surgery can lead to the identifi cation of therapeutic targets to prevent or mitigate this outcome." UNDERSTANDING WHAT DRIVES CHRONIC PAIN Experts believe that many di erent factors contribute to the transition from acute to chronic pain, including psychosocial, neurophysiologic, immunologic and metabolic factors. However, a lack of focused resea rch has stymied the development of evidence-based best practices that could be used in pain care. The Acute to Chronic Pain Signatures (A2CPS) program, funded by the National Institutes of Health Common Fund, will seek to predict patients' susceptibility or resilience to chronic pain. The study will track 3,600 people, 1,800 undergoing total knee a r throplasty a nd 1,800 having a thoracotomy. Using brain imaging, quantitative sensor y testing, psychologica l assessment and multiomics analysis, researchers will develop i nd iv idua l biom a rkers, or combi n at ion s of biom a rkers (signatures), to predict which patients will develop chronic postoperative pain. Resea rchers will collect data on patients for a period of si x months follow ing surger y, w ith the goa l of using this i n for mation to understa nd t he mecha n isms beh i nd t he development of chronic pain. "The identifi cation of individua ls at risk for the transition from acute to chronic pain before surgica l intervention will enha nce the ability of or thopedic surgeons to provide the patient a more accurate prognosis of surgica l outcomes and refi ne indications for surgica l intervention," says Dr. Jacobs, one of the physicians involved with the study. "[It will a lso help] identify individuals who may have modifi able risk factors for the transition from acute to chronic pain, which can be addressed prior to surgery in order to improve the likelihood of a pain-free outcome." The A2CPS program is part of the Helping to End Addiction Long-term Initiative, which funds hundreds of research projects throughout the country to establish scientifi c solutions to the opioid crisis. n For more information on the A2CPS program, visit a2cps.org. Acute to Chronic Pain BY ELESA SWIRGSDIN THE NIH ACUTE TO CHRONIC PAIN SIGNATURES PROGR AM WILL IDENTIF Y CHRONIC PAIN BIOMARKERS, HELPING PHYSICIANS PREDICT WHICH PATIENTS WILL DE VELOP CHRONIC PAIN. Researchers Seek to Better Understand Transition from 2 4 SPECIAL CLINICAL SECTION: ORTHOPEDICS