# Neurobiological and psychosocial risk for transition from acute to chronic musculoskeletal pain in adolescence

> **NIH NIH R01** · OREGON HEALTH & SCIENCE UNIVERSITY · 2022 · $675,361

## Abstract

Project Summary
Chronic musculoskeletal (MSK) pain problems increase dramatically in the adolescent years, with wide impact
and high direct and indirect healthcare costs. Unfortunately, adolescents with chronic MSK pain are likely to
become adults with chronic MSK pain, and also suffer from high levels of negative consequences, including
disability, poor quality of life, and poor psychosocial functioning. In the adolescent developmental period, acute
MSK pain complaints (most commonly spine, knee, and foot or ankle pain) account for a large portion of
physician visits, and recent studies estimate that about 30-35% of these youth transition from acute pain to a
chronic pain state. However, mechanisms underlying the transition from acute to chronic pain states are poorly
understood, particularly in adolescents. While there are a number of known biopsychosocial risk factors for the
development of chronic pain, better mechanistic understanding of transition between acute and chronic pain
states is crucial for the development of novel therapeutics and preventative interventions designed to stop
chronic pain before it becomes disabling and costly. The proposed study will examine both key neurobiological
and biopsychosocial risk factors that contribute to the development of chronic MSK pain in adolescents. To our
knowledge, this would be the first neuroimaging study conducted in a sample of youth presenting for treatment
for acute MSK pain. Capturing treatment-seeking adolescents with MSK pain and following these youth over the
course of the following year, will provide novel information about candidate mechanisms and risk for the transition
from acute to chronic pain states. Using resting state and task-based functional and structural magnetic
resonance imaging, alongside comprehensive self and proxy report measures of biopsychosocial history and
function, we will identify independent multimodal neurobiological components associated with acute MSK pain
and examine associations with theoretically-grounded biopsychosocial risk pathways for chronic pain in the
context of a host of environmental factors. We will then prospectively examine how these neurobiological and
biopsychosocial risk pathways (pain processing, mood, and pain related cognition) are related to pain
persistence and pain-related impact over time using parallel process latent growth curve modeling, as well as
retrospectively identify additional
state)
neurobiological phenotypes (beyond those associated with the acute MSK pain
 that differentiate individuals demonstrating pain persistence from those with symptom remission.
Participants will include adolescents, ages 11-17, with n=200 acute MSK pain and a sample of n=80 age- and
sex-matched pain-free controls, as well as a participating parent. These adolescents will be followed an
additional three times (every 3 months over a 1 year period) to examine pain persistence and pain-related
impacts over time. Determining mechanisms and moderators...

## Key facts

- **NIH application ID:** 10518627
- **Project number:** 1R01AR080228-01A1
- **Recipient organization:** OREGON HEALTH & SCIENCE UNIVERSITY
- **Principal Investigator:** Bonnie J. Nagel
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $675,361
- **Award type:** 1
- **Project period:** 2022-08-05 → 2027-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10518627

## Citation

> US National Institutes of Health, RePORTER application 10518627, Neurobiological and psychosocial risk for transition from acute to chronic musculoskeletal pain in adolescence (1R01AR080228-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10518627. Licensed CC0.

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