Pain accounts for 20-40% of primary care appointments during childhood and adolescence with musculoskeletal pain as a principal pain complaint. Pain in childhood is significant because it increases risk for pain, disability, and psychiatric disorders in adulthood. However, the mechanisms underlying the transition from acute to chronic pain in children are not known. Using a combination of psychophysical and psychological assessment, the central aim of this proposal is to understand the mechanisms that contribute to the transition from acute to chronic musculoskeletal pain in children and adolescents. The long-term goal of this K23 award is for the candidate to establish a programmatic line of patient-oriented research focused on identification of at- risk youth and prevention of chronic pain. The K23 candidate is an acting assistant professor in the Department of Anesthesiology and Pain Medicine at the University of Washington. The candidate proposes a five-year training plan with the support of faculty mentors who have expertise in pediatric pain, laboratory pain assessment, and prevention research to obtain instruction in state-of-the-art conditioned pain modulation assessment, prevention research, and training in pain assessment, diagnosis, and treatment in primary care. The University of Washington and Seattle Children's Research Institute provide excellent institutional support and resources for this award. The research plan involves three studies. Study 1 will compare clinical phenotypes of youth with acute musculoskeletal pain, chronic musculoskeletal pain, and healthy pain-free youth. Study 2 will prospectively follow a sample of youth with acute musculoskeletal pain in primary care to identify predictors of chronic pain development. Study 3 will pilot a web-based behavioral intervention for early treatment of chronic pain in primary care. These studies will lay the groundwork for future investigations examining profiles or clinical phenotypes of children in primary care who are at-risk for chronic pain; data that can inform a predictive model of chronic pain development.

Public Health Relevance

Chronic musculoskeletal pain in children and adolescents is associated with a host of negative outcomes including activity limitations and poor psychosocial functioning. Identifying psychophysical factors that predict the transition from acute to chronic musculoskeletal pain will reveal mechanisms that can allow intervention strategies to be targeted more effectively to children at risk for chronic pain. The long-term goal of this research program is to prevent the development of chronic pain in children and adolescents.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23HD071946-05
Application #
8906901
Study Section
Pediatrics Subcommittee (CHHD)
Program Officer
Cruz, Theresa
Project Start
2012-04-15
Project End
2017-02-28
Budget Start
2015-03-01
Budget End
2016-02-29
Support Year
5
Fiscal Year
2015
Total Cost
$112,858
Indirect Cost
$8,360
Name
Oregon Health and Science University
Department
Type
Schools of Medicine
DUNS #
096997515
City
Portland
State
OR
Country
United States
Zip Code
97239
Holley, Amy Lewandowski; Zhou, Chuan; Wilson, Anna C et al. (2018) The CALI-9: A brief measure for assessing activity limitations in children and adolescents with chronic pain. Pain 159:48-56
Clementi, Michelle A; Faraji, Pari; Poppert Cordts, Katrina et al. (2018) Parent Factors are Associated with Pain and Activity Limitations in Youth with Acute Musculoskeletal Pain: A Cohort Study. Clin J Pain :
Lewandowski Holley, Amy; Wilson, Anna C; Cho, Elise et al. (2017) Clinical Phenotyping of Youth With New-Onset Musculoskeletal Pain: A Controlled Cohort Study. Clin J Pain 33:28-36
Lewandowski Holley, Amy; Rabbitts, Jennifer; Zhou, Chuan et al. (2017) Temporal daily associations among sleep and pain in treatment-seeking youth with acute musculoskeletal pain. J Behav Med 40:675-681
Conrad, Nicole; Karlik, Joelle; Lewandowski Holley, Amy et al. (2017) A Narrative Review: Actigraphy as an Objective Assessment of Perioperative Sleep and Activity in Pediatric Patients. Children (Basel) 4:
Holley, Amy Lewandowski; Wilson, Anna C; Palermo, Tonya M (2017) Predictors of the transition from acute to persistent musculoskeletal pain in children and adolescents: a prospective study. Pain 158:794-801
Rabbitts, Jennifer A; Holley, Amy Lewandowski; Groenewald, Cornelius B et al. (2016) Association Between Widespread Pain Scores and Functional Impairment and Health-Related Quality of Life in Clinical Samples of Children. J Pain 17:678-84
Noel, Melanie; Wilson, Anna C; Holley, Amy Lewandowski et al. (2016) Posttraumatic stress disorder symptoms in youth with vs without chronic pain. Pain 157:2277-84
Lewandowski Holley, A; Rabbitts, J; Durkin, L et al. (2016) (101) Temporal daily associations among sleep and pain in treatment-seeking youth with acute musculoskeletal pain complaints. J Pain 17:S1
Holley, A L; Wilson, A C; Noel, M et al. (2016) Post-traumatic stress symptoms in children and adolescents with chronic pain: A topical review of the literature and a proposed framework for future research. Eur J Pain 20:1371-83

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