Chronic pain is a major public health issue with significant functional and financial consequences affecting individuals, the community, and the healthcare system. Even more concerning, the consequences of chronic pain extend beyond disability and decreased quality of life to include an increased incidence of morbidity and mortality. Research investigation and clinical management of chronic pain is difficult due to significant individual variability and the lack of biological indices with which to evaluate risk and protective factors, progression, and treatment response.
Deciphering the Code
Assessing the Stage of Chronic Pain

Biological Burden
Determing the Biological Burden of Chronic Pain

Neurobiological Interface
Evaluating the Neurobiological Interface of Pain

Dispositional Traits
Influence of Dispositional Traits on Chronic Pain and Health Outcomes

Delineating Resilience
Resilience Factors in Chronic Pain

Interventional Approaches
Non-Invasive and Non-Pharmacological Treatments for Chronic Pain

Unraveling Health Disparities
Understanding the Complex Array of Factors Contributing to Disparities in Chronic Pain

Reciprocal Translation
Research Benefiting Horses and Humans

Deciphering the Code of Chronic Pain -Assessing Stage of Chronic Pain
Characterizing the severity of chronic pain is essential in order to interpret the biological interface of chronic pain and related psychosocial and biobehavioral risk and resilience factors. Our research aims to measure the biological interface of chronic pain and associations with health outcomes such as physical and cognitive functioning.
Associated Publications:
Chronic Pain Severity and Sociodemographics: An Evaluation of the Neurobiological Interface. PMID: 34425249
Relationships between chronic pain stage, cognition, temporal lobe cortex, and sociodemographic variables. PMID: 33720889
Accelerated Aging in Adults with Knee Osteoarthritis Pain: Consideration for Frequency, Intensity, Time, and Total Pain Sites. PMID: 29392207
Investigating the burden of chronic pain: Inflammatory and metabolic composite. PMID: 27445627
Determining the Biological Burden of Chronic Pain
Our research aims to identify biological measures of system burden in individuals with chronic musculoskeletal pain and establish a clinical composite that can be used in patient care to evaluate the burden of chronic pain and assess changes resulting from clinical interventions.
Associated Publications:
Accelerated Aging in Adults with Knee Osteoarthritis Pain: Consideration for Frequency, Intensity, Time, and Total Pain Sites. PMID: 29392207
Allostatic load and pain severity in older adults: Results from the English Longitudinal Study of Ageing. PMID: 27988258
Investigating the burden of chronic pain: Inflammatory and metabolic composite. PMID: 27445627
Chronic pain, perceived stress, and cellular aging: an exploratory study. PMID: 22325162
Telomeres and epigenetics: Potential relevance to chronic pain. PMID: 22770844
Evaluating the Neurobiological Interface of Pain
Our research focuses on understanding the complex relationships between chronic pain, resilience, and the brain with consideration for sociodemographic factors.
People don’t come preassembled but glued together by life. Each time one of us is constructed, a different result occurs. LeDoux, (2002, p.3)
Associated Publications:
Chronic Pain Severity and Sociodemographics: An Evaluation of the Neurobiological Interface. PMID: 34425249
Relationships between chronic pain stage, cognition, temporal lobe cortex, and sociodemographic variables. Journal of Alzheimer’s Disease. PMID: 33720889
Resilience, Pain, and the Brain: Relationships Differ by Sociodemographics. PMID: 33606287
Investigating the Role of Dispositional Traits
Dispositional traits are notable at birth, observable across all mammals, and are neurobiologically based. Predictive of behavior and mental and physical health conditions, dispositional traits are also associated with clinical pain experiences and pain-related functioning. Our research investigates the influence of dispositional traits on chronic pain and health outcomes. Individualizing interventions based on temperament represents an important target to improve treatment compliance. Additionally, as temperament is malleable across the life-span, interventions that aim at modifying specific traits represent a critical and essential target to improve chronic pain treatment.
Associated Publications:
Vulnerable Dispositional Traits and Chronic Pain: Predisposing but not Predetermining. PMID: 34856411
Affect balance style, experimental pain sensitivity, and pain-related responses. PMID: 22367502
Affect and low back pain: More to consider than the influence of negative affect alone. PMID: 26889620
Delineating Resilience in Chronic Pain
Risk factors represent well-traveled paths in pain research. Resilience factors in chronic pain represent important targets on less traveled paths. Our research focus on identifying and measuring biobehavioral and psychosocial resilience factors. There are a number of recognized risk factor indexes. One initiative under way is the development of a clinically relevant resilience index.
Associated Publications:
Resilience, pain, and the brain: Relationships differ by sociodemographics. PMID: 33606287
Resilience factors may buffer cellular aging in individuals with and without chronic knee pain. PMID: 30900507
Omega-6: Omega-3 PUFA Ratio, Pain, Functioning, and Distress in Adults With Knee Pain. PMID: 28542024
Associations between Vitamin D, Omega 6: Omega 3 ratio, and Biomarkers of Aging in Individuals Living with and without Chronic Pain. PMID: 35057447
Strategies to Bolster Treatment and Reduce Chronic Pain
There is an increased need for non-invasive and non-pharmacological treatments for chronic musculoskeletal pain. Informed by our research investigations of biobehavioral and psychosocial protective factors, our research focuses on strategies with potential to optimize pain treatments and to increase the learning and memory of health promoting experiences.
Associated Publications:
Intermittent Fasting: Potential Utility in the Treatment of Chronic Pain across the Clinical Spectrum Full Article
Blood flow restriction exercise to attenuate postoperative loss of function after total knee replacement: a randomized pilot study. PMID: 34459574
Optimizing chronic pain treatment with enhanced neuroplastic responsiveness: A pilot randomized controlled trial. Full Article
Increasing neuroplasticity to bolster chronic pain treatment: A role for intermittent fasting and glucose administration? PMID: 26848123
Omega-6:Omega-3 ratio, pain, functioning, and distress in adults with knee pain. PMID: 28542024
Understanding the Complex Array of Factors Contributing to Disparities in Chronic Pain
Improving our understanding of factors contributing to disparities in chronic musculoskeletal pain will require investigations at all levels of analyses from environmental to biological. Additionally, research capturing risk and resilience factors and exploring similarities as well as differences is essential moving forward.
Associated Publications
Applying the NIA Health Disparities Research Framework to Identify Needs and Opportunities in Chronic Musculoskeletal Pain Research. PMID: 34280570.
Relationships between chronic pain stage, cognition, temporal lobe cortex, and sociodemographic variables. Journal of Alzheimer’s Disease. PMID: 33720889
Resilience, pain, and the brain: Relationships differ by sociodemographics. PMID: 33606287
Relationships Between Pain, Life Stress, Sociodemographics, and Cortisol: Contributions of Pain Intensity and Financial Satisfaction. PMID: 33403312
Knee pain trajectories over 18 months in non-Hispanic Black and non-Hispanic White adults with or at risk for knee osteoarthritis. Full article.
Reciprocal Translation: Research Benefiting Horses and Humans
Horses and humans have much in common. Horses provide an excellent model to investigate: 1) temperament; 2) evidence-based strategies to promote learning, memory, and behavior change; 3) the benefits of positive reinforcement; and 4) approaches to promote more optimal behavior in those with vulnerable traits. Horses, humans, and the horse/human relationship will benefit from an improved understanding informed by science.
Associated Publications:
The Evidence and Application of Positive Reinforcement Training in the Horse. (In Development)
Effect of maternal docosahexaenoic acid supplementation on behavior and cognitive development in nursing foals. http://dx.doi.org/10.1016/j.jevs.2013.03.100
Maternal fatty acid supplementation influences memory and learning ability in yearling and 2-year-old horses. DOI: http://dx.doi.org/10.1016/j.jevs.2015.03.094