This Phase I research program will develop a web-based/mobile cognitive therapy program for the treatment of chronic pain. The cognitive therapy strategies used were developed using quantitative patient pain testing and real-time fMRI brain imaging. Chronic pain is one of the largest public health problems in the United States. Approximately 100 million U.S. adults suffer from chronic pain conditions by NIH estimates, imposing a staggering annual cost of over $500 billion when health care expenditures and lost productivity are considered. In addition, the sharp increase in the use of prescription opioid medication for chronic pain has become a major public health concern. In contrast, growing evidence supports the efficacy and cost-effectiveness of psychosocial and self-management treatment models for pain. There are important advantages to delivering cognitive treatments online, including lower cost, wider availability, uniform delivery, and the ability to tailor treatent programs to the individual. This research will conduct a randomized, controlled, clinical trial of this novel investigative therapeutic technology. The intervention will focus on improving control over pain and self- management of symptoms. The clinical endpoints are decreased pain symptoms, and improved volitional control over pain. These investigations further the NIH mission by developing a novel therapeutic modality based upon prior neuroimaging research and internet technologies for alleviating a condition which is responsible for substantial human suffering and healthcare cost.
We plan to develop and test a web-based/mobile cognitive therapy program to facilitate self-management of chronic pain. This is an important clinical application based on neuroimaging and web/mobile technologies that could decrease pain in a large number of patients nationwide at very low cost and low risk. Chronic pain represents one of the most serious public health problems in the United States.