Pain is a critical national health problem. It is the most common reason for medical appointments, and costs this country over $100 billion each year in health care and lost productivity. Chronic pain affects more than 50 million Americans per year. Pain often results in disability and, even when not disabling, it has a profound effect on the quality of life. Its deleterious effects have been demonstrated in morbidity, immune function, sleep, cognition, eating, mobility, affective state, psychosocial behaviors, and overall functional status. In the hospitalized patient, pain may be associated with increased length of stay, longer recovery time, and poorer patient outcomes, which in turn have health care quality and cost implications.
The NIH Pain Consortium was established in 1996 to enhance pain research and promote collaboration among researchers across the many NIH ICs that have programs and activities addressing pain. Currently, the research interests of twenty-one NIH Institutes, Centers, and Offices are represented in the Consortium. Although these combined efforts have resulted in great scientific progress, the understanding and treatment of pain remains incomplete. Congress declared 2001 to 2010 the Decade of Pain Control and Research. NIH continues to be responsive to and in alignment with this decade. In presenting new pain findings, the April 2006 NIH Pain Consortium symposium “Advances in Pain Research” reiterated this need for an ongoing multidisciplinary research agenda that will ultimately lead to the prevention or effective treatment of unwanted pain.
The NIH Pain Consortium requests research on all conditions in which pain is a prominent feature. Of interest are conditions, such as cancer, that of themselves or their treatment may result in pain. Many primary conditions, whether acute (such as injury), recurring (such as migraine), or chronic (such as arthritis) are significantly complicated by comorbid pain. Some pain conditions are unassociated with other primary diagnoses. Chronic pain is widely believed to represent a disease itself, causing long-term detrimental physiologic changes and requiring unique assessments and treatments. Although not an exhaustive listing, and in addition to the areas of research detailed below in this FOA, of special interest are the following acute and chronic pain conditions:
- Back pain and other musculoskeletal pain
- Cardiovascular pain disorders
- Chemotherapy-induce neuropathies and other malignant disorders
- HIV/AIDS related pain
- Neuropathic pain
- Osteoporotic pain
- Pain associated with communication disorders (e.g., otitis media, tinnitus, burning mouth syndrome, dysphagia)
- Pain at the end of life
- Pain in older persons with multiple contributing morbidities
- Pain in people with drug and alcohol addictions
- Pain in persons with neuromuscular conditions
- Pain in preterm neonates exposed to multiple medical interventions
- Skin disorders and pain
- Spinal cord injury pain
- Temporomandibular joint and muscle disorders
New and innovative advances are needed in every area of pain research, from the micro perspective of molecular sciences to the macro perspective of behavioral/social sciences. Although great strides have been made in some areas, such as the neural pathways of pain, pain and the challenge of its treatment have remained uniquely individual and largely unsolved. Proposals that seek to improve the understanding of the causes, costs, and societal effects of both acute and chronic pain and the relationships between the two are highly encouraged. Additionally, proposals that link such understandings to the development of better approaches to therapeutic interventions, including complementary and alternative medicine (CAM) interventions, and management of acute and chronic pain are in keeping with the current translational focus of NIH and are encouraged.