Scientific Summit Schedule of Events
Hear the latest in pain research from experts as they share emerging science and how it translates to clinical practice. All events and educational programming will take place at the Disneyland® Hotel.
Sunday, March 4, 2018 | Preconference Events
8 am–12 pm
A Patient-Oriented Approach to Navigating the Transition from Acute to Chronic Pain: A Fundamental Course
Charles Argoff, MD
Burel Goodin, PhD
Theodore Price, PhD
Examine patient cases and explore the basic, translational, and clinical science that is elucidating the acute to chronic pain transition.
Preregistration is required; there is a $100 fee to attend.
Six-Building Blocks Workshop: Implementing Team-Based Management of Chronic Opioid Therapy
Primary care clinicians, pain medicine and behavioral specialists, as well as clinic directors and administrators are invited to attend this preconference course to learn the concrete steps necessary to implement an effective interdisciplinary office-based pain management practice while utilizing evidence-based treatment.
Preregistration is required; there is a $100 fee to attend.
8 am–4 pm
Conference on Analgesic Trials
Neil Singla, MD
Expert panelists from regulatory bodies, industry, and academia discuss the latest thinking on increasing the reliability and accuracy of analgesic trials.
Preregistration is required; there is a $150 fee to attend.
1–4:15 pm
Early Career Forum
Connect with senior mentors and attend breakout sessions to focus on your career development.
Preregistration is required and is part of the full conference registration. This event is limited to 120 attendees.
4:30-6 pm | Early Career Professional Reception
6-7:30 pm | Clinical and Basic Science Data Blitz
7:30-9 pm
Basic Science Dinner
Scientific Communication: Thinking Outside of the Peer Review Box
Panelists:
Joe Palca
Science Correspondent, National Public Radio
Theodore Price, PhD
Associate Professor, UT Dallas
Stephani Sutherland, PhD
Neuroscience Writer Pain Research Forum, Scientific American and Scientific American Mind
Monday, March 5, 2018
6-7 am | New this year – YOGA!
Join us for a one hour yoga class and know that your donation will advance Pain Research! Whether you are brand new to yoga or a life-time yogi, this Hatha-based practice will bring calm focus, stretching and increased breath awareness. Yoga mats and water are available. Thank you for your donation to the Pain Research Fund.
7 am | Breakfast in the Experience Exchange
7:30–8 am | Gathering and Welcome
8–8:30 am | Plenary Lecture
The Biology of Infant and Childhood Pain: It All Begins Here
Maria Fitzgerald, FMedSci FRS
Infants respond to noxious stimulation from birth, but the neural pathways underlying pain behavior and pain perception change through infancy, childhood, and adolescence. Evidence from animal models and clinical studies have demonstrated important epochs in nociceptive information processing through development. Understanding how pain is processed at each stage has considerable impact upon the clinical assessment and treatment of pain in children. The development and plasticity of cortical pain networks underlying the perception and memory of pain is an important area of recent research, particularly as there is increasing evidence that pain and stress in childhood may alter brain development and impact upon future adult pain sensitivity.
8:30–9 am | Plenary Lecture
Variability in the Pain Experience after Injury
James C. Eisenach, MD
Physical, metabolic, or chemical injury to tissues typically results in acute pain followed by resolution. Individuals vary considerably not only in the degree of resolution but also in the speed of this process. Recent work is exploring the day to day profess of resolution from pain after the physical injury of major surgery and probing biologic mechanisms responsible for this variability which might be manipulated to speed recovery in all and prevent or diminish the likelihood of long lasting severe pain in the few with this problem. This lecture will summarize these results and discuss current hypotheses on the psychosocial, genetic, and neurobiologic factors which underlie this variability as well as clinical trials testing how these can be manipulated to speed recovery.
9:15 – 10:45 am | Concurrent Symposia
Exploiting Cellular and Molecular Mechanisms of Neuroinflammation for New Treatments of Chronic Pain
Jelena Janjic, PhD
Theodore Price, PhD
Edgar Alfonso Romero-Sandoval, MD PhD
Neuroinflammation is a promising, yet highly complex target for development of next-generation, precision medicine-based approaches to address pressing need for highly personalized and effective, non-opioid solutions for chronic pain resulting from injury, trauma, or surgery. This symposium highlights new advances in exploring key cellular and molecular mechanisms of neuroinflammation through integrated utilization of pharmacological, genetic, and nanotechnology approaches.
Migraine and Sleep Deficiency in Adolescents: Understanding Shared Mechanisms from Bench to Bedside
Emily Law, PhD, @EmilyLawPhD
Christopher King, PhD, @kingneuro
Paul Durham, PhD
This symposium will present current state-of-the-science research on shared mechanisms between sleep deficiency and migraine using translational and clinical examples. Perspectives and methodologies from basic and clinical scientists will be described, including molecular migraine models, brain neuroimaging, actigraphy monitoring, and self-report data. Discussion will include potential treatment strategies targeting co-occurring migraine and sleep deficiency in adolescents.
Psychological Treatments for Chronic Pain: Who Benefits & Why?
Melissa Day, PhD
Beverly Thorn, PhD
Mark Jensen, PhD
In order to develop patient-treatment matching algorithms and to streamline and optimize evidence-based psychological treatments for chronic pain, there is a need to advance our understanding of treatment mechanisms. Presenting and testing two theory-driven mechanism models, this symposium will provide an in-depth analysis of for whom are several of the currently widely used psychological treatments most likely to benefit (moderation), and why are these treatments effective (mediation).
Putting the Spotlight on Social: An Innovative Multidisciplinary, Multi-Species Approach for Examining the Influence of Social Context in Pain
Kristen Jastrowski Mano, PhD
Loren Martin, PhD
Kai Karos
This multidisciplinary symposium will present novel data from three unique perspectives on social mechanisms modulating the pain experience of laboratory animals, healthy individuals, and those suffering with chronic pain. Presenters will provide insight into (1) the fundamental mechanisms that engage the neural circuits responsible for pain modulation via social context, (2) the effect of a threatening social context on the perception and expression pain, aggression, and empathy; and lastly (3) how attentional bias to social threat may represent an important mechanism involved in the comorbidity of chronic pain and anxiety among pediatric chronic pain patients.
11 am-12 pm | Shared Interest Group Meetings
Measurement of Pain and Its Impact, Geriatric Pain, and Nursing
Elizabeth Felix, Phd
Joseph Riley III, PhD
Keela Herr, RN FAAN PhD
Susan Marden, PhD
The Geriatric Pain, Measurement of Pain and Its Impact, and Nursing Shared Interest Groups will combine its meetings during this year's Summit. We will focus on general concepts of pain measurement and assessment in older individuals. Special considerations will be presented with regard to assessment in individuals with limited ability to communicate due to cognitive impairments. Efforts to translate the current science of pain measurement to improve management of pain will be discussed. Pain is a prevalent symptom in older adults with a significant societal impact. Its complexity poses ongoing challenges in both its measurement and treatment. The first step in providing quality care for persons with pain is valid and accurate assessment, which can provide information about pathophysiologic mechanisms of pain. During this session, presenters will review clinical and experimental concepts about pain measurement, with emphasis on mechanism-based measurement and assessment in older individuals including those with cognitive impairment. Dr. Joseph Riley III, Professor in the College of Dentistry at the University of Florida, will discuss assessment of central and peripheral mechanisms of pain. Dr. Keela Herr, Professor in the College of Nursing at The University of Iowa, will discuss pain measurement in non-verbal older adults, focusing on "common data elements" needed for pain observation tools, the Pain Assessment in Impaired Cognition (PAIC) meta-tool, and how current tools address pain mechanisms (or lack thereof). The NIH-supported Person-Centered Assessment Resource Initiative (1U2CCA186878-01) will also be discussed. Dr. Elizabeth Felix (co-chair of the Pain Measurement and Its Impact SIG) will serve as the moderator, providing the background and scope of the challenges associated with pain measurement.
This SIG meeting offers 1.0 hour of CE credit.
Pain and Disparities
Mary Driscoll, PhD
Beverly Thorn, PhD
The Pain and Disparities SIG meeting will feature a panel discussion of behavioral interventions targeting mechanisms of pain disparities. While disparities in pain severity and treatment based on race, gender, and socioeconomic status have been well-documented in the U.S. population, the mechanisms producing these disparities are still not well understood. However, by developing and testing pain-management interventions tailored to the needs of specific disadvantaged groups, we can gain important insight into potential mechanisms of pain disparities and how best to target them.
Speakers Mary Driscoll, PhD (VA Connecticut Healthcare System) and Beverly Thorn, PhD (University of Alabama) will discuss their innovative chronic pain interventions designed for underserved populations and offer behind-the-scenes information about their experiences designing and implementing these interventions. Brief presentations by each speaker will be followed by a moderated discussion to highlight cross-cutting issues in working to improve pain care in underserved populations; explore implications for understanding mechanisms underlying pain disparities; and to consider how pain research across multiple disciplines can both inform, and be informed by, a disparities “lens.”
The annual Pain and Disparities SIG Young Investigator Poster award will also be presented.
This SIG meeting offers 1.0 hour of CE credit.
Pain in Sickle Cell Disease
Carlton Dampier, MD
Wally Smith, PISCEs
The Pain in SCD SIG seeks to foster the development of a multidisciplinary community that brings together pain researchers, including basic scientists, clinicians, nurses, psychologists, and other health professionals to increase the understanding of pain in sickle cell disease and its treatment. An update on the SIG's collaborative activities with the ACTTION-APS AAPM Pain Taxonomy Project and the ASH SCD Coalition will be provided at the SIG meeting, followed by a discussion of the draft Acute Pain Taxonomy and new analyses of data from the PISCEs study.
Headache SIG Business Meeting
Gregory Dussor, PhD
Dr. Andrew Ahn
The SIG will discuss goals and priorities, appoint its first co-chair, and decide on the format of future SIG meetings. Additionally, the SIG will discuss some of the headache/migraine-specific funding opportunities that exist.
Dr. Andrew Ahn from Eli Lilly will give an overview of the current state of CGRP-based migraine therapeutics as well as discuss the continued need for research and target identification as these new drugs begin to come online.
Genetics and Pain
This year the APS Genetics and Pain SIG will present awards to recognize Young Investigators for outstanding research on genetics and pain. These awards will highlight posters that best represent the theme of this year's meeting of Understanding Pain Mechanisms through genetic tools and discoveries. The Genetics and Pain SIG meeting will feature short presentations from the winners of the poster awards. After the poster talks, we will also take the opportunity to discuss SIG business regarding leadership changes, educational opportunities, collaborative research efforts, and goals for the coming year.
11 am – 12 pm | Classroom Symposia with Legally Mine, Inc.
Essential Legal Concepts to Avoiding Lawsuits, Reducing Taxes & Protecting Your License
Art McOmber, Legally Mine, Inc.
Through this course attendees will truly understand exactly how, why, and where legal entities should be used for both lawsuit prevention and income tax reduction. Our course is both engaging and easy to understand. When completed, attendees will have an understanding of the proper use of legal tools, and will have an organized approach to taking effective action.
12:15 – 1:15 pm | Lunch in Experience Exchange and Poster Session 1
12:15 - 12:35 pm | Solutions Theater
The (Mis)Socialization of Children's Pain Memories
Melanie Noel, PhD
12:55 - 1:15 pm | Solutions Theater
Hazardous Alcohol and Opioid Use in Chronic Pain: An Assessment of Frequency and Impact
Kevin Vowles, PhD
1:30 – 2 pm | Plenary Lecture
Spinal Mechanisms of Spinal Cord Injury-Induced Neuropathic Pain: Implications for Novel Therapeutic Targets
Susan G. Dorsey, PhD RN FAAN
According to the 2011 Institute of Medicine (IOM) report on Relieving Pain in American, chronic pain is a public health epidemic costing more than $600 billion for utilization of healthcare services and lost work wages. Not only is chronic pain resistant to conventional treatments at doses that do not reduce quality of life or increase risk for opioid misuse and addiction, but in many cases, chronic pain with a neuropathic component worsens over time. The most common definition of neuropathic pain is pain that is caused by a disease of, or damage to, the somatosensory nervous system. Hallmarks include episodic or continuous pain arising from normally non-painful stimuli (allodynia) and/or unpleasant, abnormal sensations termed dysesthesias. Our research has focused on spinal cord injury (SCI)-induced neuropathic pain. The majority of SCI patients report long lasting neuropathic pain at or below the level of the lesion and rate the intensity as moderate to severe. Unfortunately, there is limited information regarding the mechanisms underlying spinal cord injury-induced chronic neuropathic pain and most pharmacological and non-pharmacological therapies provide inadequate pain relief. Given this, the identification of novel therapeutic targets that might be exploited to reduce or eliminate chronic SCI-induced pain are critically needed. Early after SCI, reactive astrocytes undergo morphological changes and demonstrate enhanced proliferation, migration, and synthesis of glial fibrillary acidic protein (GFAP), leading to the formation of the glial scar. While the glial scar can be protective, it can also limit axonal regeneration. In addition, changes in glial cells post-SCI can also contribute to neuropathic pain through production of chemokines, pro-nociceptive growth factors and cytokines. We have been focused on the potential role of the truncated Brain-derived neurotrophic factor (BDNF) receptor, tropomyosin-related kinase B T1 (trkB.T1), in SCI-induced neuropathic pain. While BDNF has been shown to be a potent modulator of pain signaling by binding of mature BDNF to its catalytically-active full-length receptor, trkB.FL, much less is known about the function of the truncated trkB.T1 receptor and its possible role in pain signaling. However, we and others have shown that trkB.T1 receptor expression is up-regulated at early and late timepoints following SCI in rodent models, coincident with the development of nocifensive responses and locomotor dysfunction. Since astrocytes, which are the main component of the glial scar, express only the truncated isoform of the BDNF receptor trkB, we reasoned that trkB.T1 signaling in astrocytes could be contributing to the formation of the glial scar and in turn, neuropathic pain and locomotor dysfunction. Our data to date demonstrate that genetic deletion of trkB.T1 globally or specifically in astrocyte only, demonstrate less mechanical and thermal hypersensitivity, reduced mechanical hyperesthesia and better locomotor recovery following injury. We conducted differential gene expression analyses in cultured astrocytes derived from neonatal trkB.T1 knockout mice to examine transcriptional differences associated with the loss of trkB.T1, and found that genes related to proliferation and migration were significantly reduced relative to wildtype controls. These findings were confirmed in functional assays, in which we found that the lack of trkB.T1 significantly decreased both proliferation and migration in response to serum and exogenous BDNF application. In vivo in the spinal cord, we also found reduced astrocyte proliferation and gliopathy following SCI. These results provide mechanistic insight into post-SCI neuropathic pain provide insight into the contribution of trkB.T1 signaling in astrocytes.
2 – 2:30 pm | Plenary Lecture
Assessment and Management of Neuropathic Pain: Advances, Challenges, and Opportunities
Srinivasa Raja, MD
The Neuropathic Pain Special Interest Group (NeuPSIG) of the International Association for the Study of Pain suggested in 2008 that neuropathic pain (NP) be redefined as “pain arising as a direct consequence of a lesion or disease affecting the somatosensory system.” Considering the clinical presentations and possible confirmatory diagnostic tests, a revised grading system was published to better reflect clinical practice and allow appropriate treatment decisions to be made, despite diagnostic uncertainty. Extensive research in the last two decades have contributed substantially to our understanding of the pathophysiologic mechanisms of NP. However, the clinical management of NP continues to be challenging with only a minority of patients achieving a satisfactory response from drug therapy. A number of evidence-based clinical practice guidelines for the pharmacologic and interventional management of NP have been published in recent years with stepwise recommendations. These guidelines highlight factors that contribute to therapeutic challenges, such as modest efficacy of the active drugs, high placebo response in trials, the heterogeneity of NP patients and an inadequate classification of patients included in clinical trials. Recent reports emphasize the heterogeneity of the etiology, mechanisms, and clinical presentations of patients with NP and suggest algorithms for stratifying patients, based on their sensory profiles. This research direction offers the opportunity for developing a personalized, multimodal approach to the management.
2:45 – 4:15 pm | Concurrent Symposia
At the Intersection of Affect Regulation, Reward/Value Processes, and Placebo: Altered Human Psychological, Neurobiological, and Opioidergic Systems in Chronic Pain
Katherine T. Martucci, PhD, @DrKatieMartucci
Afton Hassett, PsyD, @AftonHassett
Jon-Kar Zubieta, MD PhD
This symposium will consist of an interactive and integrated basic science, psychological, and clinical research perspective with presentations of new and emerging data from research conducted with human participants. Topics discussion will focus on of the interactions between altered pain psychology and behavior, endogenous opioid system dysfunction and variability, and neurobiological alterations in individuals with chronic pain.
Mechanism-Based Approach to Clinical Trial Design in Chemotherapy-Induced Peripheral Neuropathy
Jennifer Gewandter, PhD
Patrick Dougherty, PhD
Roy Freeman, MD
This symposium will address considerations for designing mechanistically informed clinical trials, including eligibility criteria, patient-reported assessments, and biomarkers based on the current understanding of basic and clinical science mechanisms, neurobiology, and clinical course of painful CIPN. Considerations presented in this workshop will be generalizable to clinical trial design in other pain conditions.
Muscle Pain Mechanisms: It’s Time to Dive Deep
Kathleen Sluka, PT PhD, @ksluka0101
Michael Jankowski, PhD
Cheryl Stucky, PhD
The purpose of this session is to highlight the critical need for greater research on muscle and deep tissue afferents in preclinical and clinical studies for chronic pain. Deep tissue sources driving and maintaining chronic pain are vastly understudied compared to cutaneous sources or to non-target-identified sensory somata. Further, the session will tether clinical studies and human tissue investigations of deep afferent pain together with preclinical studies, with the goal of higher bidirectional translation between preclinical models and patients.
This symposium is dedicated to the memory of Edward R. Perl, MD, and William D. Willis, Jr., MD PhD, both of whom made seminal contributions to the fields of pain and neuroscience.
Novel Mechanisms Underlying Risk for Acute and Chronic Post-Surgical Pain: Role of Peripheral Pain Processing, Central Sensitization, and Genomics
Vidya Chidambaran, MD, @Vidyachidambar1
Jennifer A. Rabbitts, MD, @JARabbitts
Chad Brummett, MD
In this session, clinical scientists will present a multi-faceted discussion of their research findings on the impact of pain processing phenotypes (quantitative sensory testing), psychosocial factors, central sensitization, genomics, and gene-environmental interactions on acute post-surgical pain, opioid responsiveness, and the development of chronic post-surgical pain.
4:30 - 4:50 pm | Solutions Theater
Sex Differences in Pain and Analgesia
Inna Belfer, MD PhD
4:30– 5:30 pm | NIH Session
Clinical Trials Panel Discussion
Susan Marden, PhD RN
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Lanay Mudd, PhD
National Center for Complementary and Integrative Health (NCCIH)
Question and Answer session with NIH Program Officers
4:30– 5:30 pm | Networking and Collaboration
Come and meet a plenary speaker, find a new collaborator, and talk to an expert in an area you want to learn more about in small group discussions.
Developmental Mechanisms and Special Populations
Group Leaders
Laura Simons, PhD: Cognitive-Affective Mechanisms of Persistent Pain across Development
Barbara Rakel, PhD RN: Postoperative Pain Mechanisms
Susmita Kashikar-Zuck, PhD: Mechanisms of Juvenile Fibromyalgia
Bill Zempsky, MD MPH: Mechanisms of Acute and Chronic Sickle Cell Pain
Cheryl Stucky, PhD: Discovering and Developing Collaboration in Novel Pain Areas
Central, Peripheral, and Psychosocial Pain Mechanisms
Group Leaders
Roger Fillingim, PhD: Forget About Where it Hurts, Let's Figure Out Why it Hurts
Robert Coghill, PhD: Central Pain Mechanisms
Chad Brummett, MD: Centralized Pain as a Predictor of Patient Outcomes
Jennifer Haythornthwaite, PhD: Pain Catastrophizing
John Burns, PhD: Mechanisms and Outcomes of Psychosocial Pain Treatments
Neuropathic Pain, Exercise, and Cannabinoids
Group Leaders
Susan Dorsey, PhD RN FAAN: Multi-Omics Associations with Chronic Pain Conditions and the Transition from Acute to Chronic Pain - Biomarker Development
Srinivasa Raja, MD: Novel Peripheral Targets for Neuropathic Pain
Patrick Dougherty, PhD: The Role of Ectopic Spontaneous Activity in DRG Neurons in Driving Neuropathic Pain
Mark Wallace, MD: Cannabinoids in Pain Management
Kathleen Sluka, PhD PT: Translational Research and Basic Science Mechanisms
5:10 - 5:30 pm | Solutions Theater
Sensory Neuron-Restricted CB1R Does Not Mediate Analgesia
Michael Burton, PhD
5:45 – 7:45 pm | Awards Reception
Sponsored in part by the Rita Allen Foundation
Tuesday, March 6, 2018
6-7 am | New this year - YOGA!
Join us for a one hour yoga class and know that your donation will advance Pain Research! Whether you are brand new to yoga or a life-time yogi, this Hatha-based practice will bring calm focus, stretching and increased breath awareness. Yoga mats and water are available. Thank you for your donation to the Pain Research Fund.
7-7:30 am | Breakfast in the Experience Exchange
7:30 - 8:30 am | NIH Session
Tips for the Mid-Career Investigator Panel Discussion
Lanay Mudd, PhD
National Center for Complementary and Integrative Health (NCCIH)
Linda Porter, PhD
National Institute of Neurological Disorders and Stroke (NINDS)
Question and Answer session with NIH Program Officers
7:30-8:30 am | Shared Interest Group Meetings
Psychosocial Research
Beth Darnall, PhD
Pat Carroll, MD
This program will highlight the shifts in opioid prescribing practices for patients with chronic pain that have been proposed by several major national organizations (e.g., the CDC). Based on evidence summarized in multiple systematic reviews, it is now clear that opioid therapy is not indicated for the long-term treatment of most chronic pain disorders. At the same time, long-term opioid exposure substantially increases the risk for problematic opioid use, addiction, and overdose. Consequently, both primary care and tertiary care clinics are increasingly faced with the complex clinical calculus of managing pain, opioid withdrawal, and the mental health of patients being tapered off long-term opioid therapy. Our goal is to discuss the empirical bases and practical challenges of tapering patients with chronic pain off opioids. We will approach this from the perspective of inpatient chronic pain rehabilitation and outpatient pain management. Special attention will be paid to the psychosocial characteristics that contribute to different responses to opioid taper, as well as the potential utility of psychosocial treatments over the course of an opioid taper. Learning Objectives 1) Present an overview of the current opioid epidemic, how it has altered pain management practices, and the current challenges facing physicians and other health care providers when treating patients on longstanding opioid therapy regimens. 2) Describe the evidence for psychosocial therapies as adjuncts and/or alternatives to pharmacological approaches to opioid taper in patients with chronic pain. 3) Describe the similarities and differences between inpatient and outpatient opioid taper.
This SIG meeting offers 1.0 hour of CE credit.
Clinical Trials SIG Business Meeting
Neil Singla, MD
The SIG business meeting will serve as a forum to discuss the future of the SIG and feedback on the SIG's scientific pre-con, the APS Conference on Analgesic Trials (Sunday March 4).Pain Education
Pain Education
Explore advances in pain education across the learning continuum (UME, GME, CME/MOC/MOC, IPE). - Review teaching modalities used in pain education - Analyze the use of competency-based medical education in pain medicine - Appraise contemporary research on pain education
Primary Care
David Tauben, MD
Jessica Merlin, MD
This session will serve as the primary care SIG's annual meeting. In addition to conducting annual business, we will have two brief talks of interest to our SIG members: 1. Six Building Blocks, 2. Pain in Primary Care Update.
This SIG meeting offers 1.0 hour of CE credit.
Basic Science
The Basic Science SIG meeting will feature two talks by recipients of the Future Leaders in Pain Research Award. Agenda items include a brief discussion of how pain scientists can better interact with government and media, and opening the floor for nominations for the 2018 incoming SIG Co-Chair.
8:45-9:15 am | Plenary Lecture
Taking Aim is Easier when You Know the Target: Moving Toward Mechanism-Based Pain Assessment
Roger B. Fillingim, PhD
Existing treatments for chronic pain produce meaningful therapeutic benefit for only a minority of patients, and we have limited ability to predict which patients will benefit from which treatments. Current approaches to pain assessment and diagnosis provide little information regarding the mechanisms underlying patients’ pain. Because pain treatments target underlying mechanisms, this represents a major barrier to improving clinical outcomes. Thus, mechanism-based approaches to pain assessment have the potential to enhance treatment outcomes by better matching patients to the appropriate treatments. This session will explore the topic of mechanism-based pain assessment. First, the multiple categories of pain mechanisms will be described. Then, several examples of strategies available for mechanism-based pain assessment will be provided, including systematic measurement of pain characteristics, symptom-based clustering of patients, and quantitative sensory testing. Emerging evidence will be reviewed suggesting that these methods may enhance patient phenotyping leading to improved prediction of treatment outcomes. The session will conclude with clinical recommendations and some possible directions for possible research.
9:15-9:45 am | Plenary Lecture
In Pursuit of More Powerful Non-Pharmacologic Treatments for Musculoskeletal Pain with Centralized Features
Susmita Kashikar-Zuck, PhD
Safe and effective non-pharmacologic treatments that have strong and sustained effects are urgently needed for the proper management of widespread chronic pain with strong centralized components. The speaker will discuss how a novel approach to exercise – neuromuscular training, derived from injury prevention research and focusing on improving body biomechanics and movement competence can be used in combination with coping skills training to reduce pain and disability in juvenile fibromyalgia syndrome (JFM). The Fibromyalgia Integrative Training for Teens (FIT for Teens) program potentially has stronger effects on pain and disability in JFM than previously studied non-pharmacologic treatments. Results show strong improvements in self-reported pain and disability after treatment. Moreover, objectively measured improvements are seen in physical ability using technologically advanced methods including 3-dimensional motion capture of movement biomechanics. The potential for incorporation of technological advancements such as motion capture and virtual reality into behavioral treatments for centralized musculoskeletal pain will be discussed. Finally, treatment studies of this type cane be used to probe the underlying brain mechanisms of centralized pain and its treatment and point the way for exciting new research directions in pain management.
10-11:30 am | Experience, Network & Learn
10 - 11 am | Women in Leadership
Jennifer Haythornthwaite, PhD
Beverly Thorn, PhD
Seddon Savage, MD MS
Inna Belfer, MD PhD
Keela Herr, PhD RN FAAN
Join a panel discussion with some amazing women leaders to talk about leadership skills and opportunities.
11:10 - 11:30 am | Solutions Theater
Conducting Clinical Trials in Osteoarthritis of the Knee
Premier Research
Michael Kuss
11:30 am - 12:30 pm | Lunch in the Experience Exchange and Poster Session 2
12:45 - 1:45 pm | Shared Interest Group Meetings
Pain in Infants, Children, and Adolescents
Elliot Krane, MD
Steve Weisman, MD
Medical Marijuana is viable now in over 25 states. Many of these states allow medical marijuana use for children under 18 years of age. There is limited experience and loads of controversy regarding the use of medical marijuana in children and adolescents. The Pediatric SIG will host a vigorous debate regarding the use of cannabinoids in youth.
Military/Veterans
Benjamin Morasco, PhD
Travis Lovejoy, PhD
Joseph Goulet, PhD
VA and DoD have focused on modifying opioid prescribing practices for chronic pain. Efforts have addressed changes to opioid dosing and alternatives to opioid therapy, among others. Three VA researchers will discuss cutting edge research focused on modifying opioid therapy for veterans and non-veterans with chronic pain. Research will describe outcomes from a recently completed 2 site (VA, Kaiser Permanente) prospective cohort study examining opioid dose escalation among patients with chronic pain. Results will be discussed from a retrospective study using VA administrative data to characterize 12-month trajectories of pain intensity following discontinuation of long-term opioid therapy, in which 4 distinct trajectory sub-groups were identified. Patient correlates of sub-group membership will be presented. Finally, another large cohort study (N>5 million veterans) using administrative data that examined the effect of use of complementary and integrative health (CIH) interventions (e.g., acupuncture, yoga, meditation) on reducing opioid initiation, dose, or duration in veterans with musculoskeletal diagnoses and PTSD. These studies highlight important research, clinical, and policy implications for opioid management of patients with chronic pain.
This SIG meeting offers 1.0 hour of CE credit.
Ethics/Pain Rehabilitation
Tomer Anbar, PhD
Samantha Rafie, PhD
This CE event is a joint meeting of the Ethics & Pain Rehabilitation SIGs to address the growing gap between best practices for chronic pain management and the public's knowledge and access to these services. Policy and practice issues will be discussed in implementing biopsychosocial approaches to pain management. CEUs provided to attendees.
This SIG meeting offers 1.0 hour of CE credit.
Sex & Gender in Pain and Analgesia
Complementary and Alternative Medicine
Shaheen E. Lakhan, MD PhD
Felicia L Harrell, DNP (c.) MSN
Michelle Dowdy, MSN NP
The Science of Integrative Pain Management Wondering about the evidence base for integrative pain management? Attend the CAM SIG meeting and learn about the scientific evidence behind integrative medicine approaches to help manage pain. These modalities include acupuncture, aromatherapy, biofeedback, chelation, breathing exercises, diet-based therapy, energy healing therapy (Reiki), guided imagery, hypnosis, massage, meditation, mind-body exercises (yoga, tai chi, and qi gong), music therapy, supplementation and nutraceuticals, and pet therapy.
2 - 2:30 pm | Fordyce Lecture
Simplifying Evidence-Based Pain Self-Management Therapies for Chronic Pain: Rationale, Efficacy, and Implementation
Beverly E. Thorn, PhD
Chronic pain is a major public health problem in the US, unequally borne by those with income and ethnic minorities. Treatment, when available, is biomedical, expensive, and fraught with undesirable side effects. Pain self-management treatments show promise as adjuncts or alternatives, but are usually unavailable to individuals with low socioeconomic status, and have not been adapted to their education or literacy levels. This lecture presents the rationale for adapting and simplifying pain self-management treatments for individuals with chronic pain and chronic illness, explains the process of making such adaptations, examines the efficacy of these simplified treatments, and discusses the opportunities and challenges of implementing such programs in low-resourced settings.
2:30 - 3 pm | Kerr Lecture
Distributed Processing of Pain: From the Spinal Cord to the Brain
Robert C. Coghill, PhD
Historically, our knowledge of the neurophysiology of pain has been driven, in large part, by the study of single neurons. While such approaches have been valuable, they have been unable to provide adequate explanations for many aspects of clinical pain - such as spread of pain to unaffected body regions and the ability of pain to persist through a myriad of treatments. However, these aspects of pain can be better understood if one considers how populations of these neurons work together to encode nociceptive information. Over the course of nearly three decades, we have used functional imaging techniques to assess the responses of populations of neurons in the rat spinal cord and human brain. From these studies, we have identified a neural infrastructure that holds the potential to support these clinically challenging aspects of pain. Nociceptive processing is widely distributed at all levels of the central nervous system, and progressively larger populations of neurons are recruited with progressive increases in nociceptive stimulus intensity. This distributed processing mechanism creates a system that is highly resilient to disruption, while progressive recruitment of neurons within this general system provides a substrate that can allow pain to spread widely.
3:15 - 4:45 pm | Concurrent Symposia
Bottom-up vs Top-down: The Search for Effective Mechanisms in Psychosocial Treatments for Chronic Pain
John Burns, PhD
Mark A. Lumley, PhD
Karen D. Davis, PhD, @kren27
Most psychosocial interventions for chronic pain have similar effects on outcomes. Rather than continue to develop new interventions based on theory (top-down), it may prove beneficial to uncover key mechanisms most strongly predictive of favorable outcomes, and then work backward to isolate therapeutic techniques that best activate these mechanisms (bottom-up). Evidence for mechanisms associated with cognitive, behavioral, and emotion processing techniques will be presented, and brain-imaging studies will highlight evidence for links between therapy-induced changes in brain function and changes in both mechanisms and outcomes.
Descending Modulation of Pain and the Endocannabinoid System: Sites, Mechanisms, and Therapeutic Potential
Susan Ingram, PhD
David Finn, PhD
Mark Wallace, MD
Neurobiological Mechanisms Supporting Integrative and Mind-Body Therapies for Pain
Vitaly Napadow, PhD, @VitalyNapadow
Fadel Zeidan, PhD, @FadelZeidan
Richard E. Harris, PhD
Mind-body therapies, such as acupuncture and mindfulness mediation, rely on both top-down and bottom-up mechanisms of action within the central nervous system. This session will draw from recent trials applying neuroimaging and quantitative sensory testing to better understand the mechanisms supporting these Integrative Medicine approaches. A panel will engage the audience after 3 didactic lectures to discuss this topic and suggest ideas for future mechanistic research into these and similar mind-body therapies.
Novel Directions in Basic Research: Rita Allen Scholars
Katherine E. Hanlon, PhD
Arkady Khoutorsky, PhD DVM
Kyle M. Baumbauer, PhD, @KyleBaumbauer
In collaboration with the Rita Allen Foundation, basic science researchers carrying out innovative investigations into pain are chosen yearly. This session will highlight the researchers chosen in the last 2 years and their novel insights into pain mechanisms and treatment.
4:45 pm Meeting Adjourned