Treatment tailored to specific patient characteristics will have a significant positive impact on the delivery of healthcare. Using individual characteristics to effectively manage musculoskeletal pain syndromes is particularly intriguing because these conditions are commonly experienced and a burden to society. Promising information obtained from basic and pre-clinical pain research has not been translated into clinical settings to improve the management of musculoskeletal pain. This R01 Award will provide the resources for a multidisciplinary research team to investigate how pain-related psychological and genetic factors lead to the development of chronic musculoskeletal pain. Our primary hypothesis is that subjects with psychological and genetic risk factors will be more likely to exhibit elevated experimental pain sensitivity, resulting in a) increased exercise-induced shoulder pain and b) development of post-operative chronic shoulder pain. We have assembled promising preliminary data and will investigate our predictive model in two separate cohort studies that use the same psychological and genetic markers, but different pain models. This design is innovative because it allows us to investigate mechanisms involved with development of chronic pain in a controlled setting, as well as to determine whether these same risk factors have a clinically meaningful impact on post- operative shoulder pain. The ultimate goal of this line of research is to offer individualized musculoskeletal pain management based on a patient's psychological and genetic make up. This proposal represents an important first step in this process, as we will determine if the selected psychological and genetic risk factors allow for early and accurate identification of the development of chronic shoulder pain. This line of study will eventually allow us to a) conduct future randomized trials to determine if individualized treatment based on psychological and genetic risk profiles decreases the probability of developing chronic shoulder pain and b) study this predictive model in other commonly experienced musculoskeletal pain conditions (i.e. back and knee pain).

Public Health Relevance

Chronic shoulder pain is a prevalent and disabling problem for society. Promising information obtained from basic and pre-clinical studies has not been tested in clinical settings to determine if early and accurate identification of individuals likely to develop chronic shoulder pain is possible. The purpose of this study is to investigate whether psychological and genetic risk factors can be used to determine whether the development of chronic shoulder pain is likely to occur.

National Institute of Health (NIH)
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Research Project (R01)
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Study Section
Behavioral Medicine, Interventions and Outcomes Study Section (BMIO)
Program Officer
Panagis, James S
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University of Florida
Other Health Professions
Schools of Public Health
United States
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Simon, Corey B; Coronado, Rogelio A; Greenfield 3rd, Warren H et al. (2016) Predicting Pain and Disability After Shoulder Arthroscopy: Rotator Cuff Tear Severity and Concomitant Arthroscopic Procedures. Clin J Pain 32:404-10
George, Steven Z; Wu, Samuel S; Wallace, Margaret R et al. (2016) Biopsychosocial Influence on Shoulder Pain: Influence of Genetic and Psychological Combinations on Twelve-Month Postoperative Pain and Disability Outcomes. Arthritis Care Res (Hoboken) 68:1671-1680
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Coronado, Rogelio A; Bialosky, Joel E; Bishop, Mark D et al. (2015) The comparative effects of spinal and peripheral thrust manipulation and exercise on pain sensitivity and the relation to clinical outcome: a mechanistic trial using a shoulder pain model. J Orthop Sports Phys Ther 45:252-64
Simon, Corey B; Riley 3rd, Joseph L; Fillingim, Roger B et al. (2015) Age Group Comparisons of TENS Response Among Individuals With Chronic Axial Low Back Pain. J Pain 16:1268-79
George, Steven Z; Wallace, Margaret R; Wu, Samuel S et al. (2015) Biopsychosocial influence on shoulder pain: risk subgroups translated across preclinical and clinical prospective cohorts. Pain 156:148-56
George, Steven Z; Parr, Jeffrey J; Wallace, Margaret R et al. (2014) Biopsychosocial influence on exercise-induced injury: genetic and psychological combinations are predictive of shoulder pain phenotypes. J Pain 15:68-80
Valencia, Carolina; Fillingim, Roger B; Bishop, Mark et al. (2014) Investigation of central pain processing in postoperative shoulder pain and disability. Clin J Pain 30:775-86
George, Steven Z; Parr, Jeffrey J; Wallace, Margaret R et al. (2014) Inflammatory genes and psychological factors predict induced shoulder pain phenotype. Med Sci Sports Exerc 46:1871-81

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