# Mechanisms and Modification of Pain Modulatory Capacity

> **NIH NIH R01** · UNIVERSITY OF FLORIDA · 2021 · $518,048

## Abstract

Chronic pain affects over 100 million Americans, with an annual cost estimated at
over $500 billion. Reliance on opioid medications has led to an “opioid crisis” and
the need to identify alternative treatment for chronic pain. The proposed project
hypothesizes that chronic pain represents failure or suboptimal function of pain
modulatory capacity (PMC). The proposed project aims to test hypotheses about
resilience to clinically relevant pain challenges, and test multisystem
(psychological, behavioral, and neural) mechanisms underlying chronic pain.
Furthermore, the project aims to demonstrate the trainability of PMC in
asymptomatic controls, which has relevance for pain prevention, and in patients
with fibromyalgia (FM) who are hypothesized to have suboptimal PMC
(resilience) to pain challenges. We will test hypotheses about the trainability of
endogenous pain modulation based on similar processes seen in other
physiological systems. The research is highly innovative and challenges common
(and unsuccessful) conceptualizations of pain treatment and variability. A typical
target of pain treatment is reduction of pain variability, which we argue is
erroneous. We hypothesize that pain variability is a marker for PMC and
treatment should focus on increasing this capacity rather than eliminating it.
Demonstration of the modifiability of PMC will have direct translation to both
prevention of chronic pain and treatment of chronic pain.
!

## Key facts

- **NIH application ID:** 10159853
- **Project number:** 5R01AR073745-02
- **Recipient organization:** UNIVERSITY OF FLORIDA
- **Principal Investigator:** MARK D. BISHOP
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $518,048
- **Award type:** 5
- **Project period:** 2020-05-15 → 2025-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10159853

## Citation

> US National Institutes of Health, RePORTER application 10159853, Mechanisms and Modification of Pain Modulatory Capacity (5R01AR073745-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10159853. Licensed CC0.

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