# Identifying risk for transition from acute to chronic musculoskeletal pain in youth

> **NIH NIH R01** · OREGON HEALTH & SCIENCE UNIVERSITY · 2020 · $668,433

## Abstract

PROJECT SUMMARY
Musculoskeletal (MSK) pain affects 18-32% of youth and places a high level of burden on children, families,
and the health care system. During childhood, prevalence of MSK pain increases with age, placing
adolescents at highest risk. When MSK pain becomes chronic, youth experience significant psychosocial
difficulties, physical disability, and impaired school functioning. Treatment costs of pediatric chronic pain are
estimated at $19 billion annually in the United States. There is an urgent need to reduce the costs and impact
of pediatric chronic MSK pain, particularly
given
that
risk for pain, disability, and high health care use can
extend from adolescence into adulthood. A key first step is identifying mechanisms underlying the transition
from acute to chronic MSK pain in youth. A pivotal mechanism thought to underlie chronic pain is sensitization
of central pain pathways and impairment in conditioned pain modulation. Research shows differences in pain
modulation in children and adults with chronic pain compared to healthy samples, and that poor pain inhibition
predictsrisk for future chronic painin adults. A critical gap in knowledge is how pain modulation, psychosocial
factors and behavioral vulnerabilities confer risk for the transition from acute to chronic MSK pain in youth. As
outlined in the NIH's Federal Pain Strategy Research Report, evaluating
episode
prospective
individuals
the course of pain from an acute
to a chronic pain state is a top research priority. need for
 studies examining the transition from acute to chronic pain to identify transition mechanisms and
at greatest risk.
Further, the report highlights the urgent
To fill these important knowledge gaps, we propose the first large-scale longitudinal
cohort study of youth with acute MSK pain (n=300) to test a biopsychosocial model of risk for transition from
acute to chronic pain. Youth will complete assessments at 4 data waves over one year and using a
combination of: a) quantitative sensory testing of the pain modulation b) psychosocial assessment, and c)
actigraphic monitoring of sleep, the central aim is to identify mechanisms in the transition from acute to chronic
MSK pain. We will also characterize the contribution of sleep deficiencies, cognitive-affective vulnerabilities,
parent pain-specific responses, and key child demographic characteristics in conferring risk for poor pain
outcomes. The aims of this innovative study address a major gap in current pediatric MSK pain research by
informing our understanding of how pain transitions from an acute to chronic state and will provide knowledge
of early risk factors for developing chronic MSK pain. Data generated from this proposal will also directly inform
our team's development of screening protocols and targeted preventive interventions directed at youth at
greatest risk for developing chronic MSK pain. Aligning with the goals of the Federal Pain Strategy Research
Report, with this research we shift the f...

## Key facts

- **NIH application ID:** 9989786
- **Project number:** 5R01AR073186-03
- **Recipient organization:** OREGON HEALTH & SCIENCE UNIVERSITY
- **Principal Investigator:** Amy S Holley
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $668,433
- **Award type:** 5
- **Project period:** 2018-09-01 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9989786

## Citation

> US National Institutes of Health, RePORTER application 9989786, Identifying risk for transition from acute to chronic musculoskeletal pain in youth (5R01AR073186-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9989786. Licensed CC0.

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