Pitt Team Awarded $20M Grant to Continue Low Back Pain Research

An interdisciplinary team within the University of Pittsburgh Health Sciences schools and the Swanson School of Engineering has been awarded a nearly $20 million, five-year grant from the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

The study, “Whole person experience of pain: Novel integration with low back pain phenotypes,” builds upon the team’s previous research, the LB3P Center, funded from the National Institutes of Health (NIH) Helping to End Addiction Long-term (HEAL) initiative.

The original LB3P study collected a wealth of diverse information—clinical, biological, biomechanical and behavioral data—for one year from over 1,000 individuals with chronic low back pain and discovered distinct patterns, or phenotypes, of chronic low back pain.

This award will allow the team to continue following these individuals longitudinally for five more years to seek further understanding of the relationship of low back pain to other chronic pain and musculoskeletal conditions.

Learn more about the importance of this study to the public from project lead, Dr. Gwendolyn Sowa, in her own words.

What is the ultimate goal of your research?

We want to identify the right treatment for the right patient, at the right time. Care for low back pain has been fraught with trial and error approaches, resulting in sub-optimal outcomes. Our research is aimed at comprehensively examining the features that contribute to the experience of low back pain to yield more personalized treatment approaches.

Why is this research so important to the public?

Low back pain is the most common cause of mobility limitation and a top cause of disability. According to the World Health Organization, low back pain affects an estimated 619 million people and is the leading cause of disability worldwide. However, many barriers exist to recovery, and misaligned treatment approaches can lead to chronic pain or even be harmful.

Pennsylvania has been particularly hard hit by the opioid epidemic, so finding alternatives to opioid pain medications for low back pain is of utmost importance to our community. These non-pharmacological treatments may include chiropractic and physical therapy care, exercise, nutritional interventions, as well as mindfulness and other cognitive behavioral strategies to help manage pain.

In the first five years, we collected an unprecedented amount of information related to people’s experience of chronic low back pain, and we now have the incredible opportunity to extend this work to understand the evolution of back pain over time as well as how it relates to other painful conditions.

A graphic shows headshots of three women and three men — Top row, left to right: Gwendolyn Sowa, chair and professor, Department of Physical Medicine and Rehabilitation; Nam Vo, professor of orthopaedic surgery and deputy vice chair of research, Departments of Orthopaedic Surgery and Molecular and Genomic Pathology; Carol Greco, emeritus associate professor of psychiatry, Department of Psychiatry; Bottom row, left to right: Michael Schneider, director of the Doctor of Chiropractic program and professor, Department of Community Health and Rehabilitation Science; Sara Piva, interim chair, professor and director of the Physical Therapy Clinical and Translational Research Center, Department of Physical Therapy; Anthony Delitto, associate provost of digital education, professor of physical therapy and former dean of SHRS.

What kinds of people are on your research team and what will they bring to the project?

We have a wonderfully interdisciplinary team. We have clinicians from a variety of backgrounds (physiatry, anesthesia, orthopaedics, physical therapy, psychology and chiropractic), engineers, biologists and data scientists working closely together to work on this challenging problem. Because low back pain is multi-factorial, having a team with broad perspectives and expertise is paramount to identifying novel solutions to treatment.

We are collecting data on the biological, biomechanical and behavioral underpinnings of low back pain, and having world class experts in each of these domains here at Pitt provide an incredible opportunity to generate novel models that will lead to improved care.

Additionally, the study participants’ visits will continue to be completed at the Physical Therapy Clinical and Translational Research Center (PT-CTRC) research clinic in the Pitt Department of Physical Therapy.

A graphic shows headshots of two women and four men — Top row, left to right: Charity Patterson, director of the SHRS Data Center and professor, Department of Physical Therapy; Gina McKernan, assistant professor, Department of Physical Medicine and Rehabilitation; Kevin Bell, assistant professor, Department of Bioengineering, Swanson School of Engineering; Bottom row, left to right: William Anderst, director of the Biodynamics Laboratory and assistant professor, Department of Orthopaedic Surgery; Leming Zhou, director of the Master of Science in Health Informatics program and associate professor, Department of Health Information Management; Ajay Wasan, vice chair for Pain Medicine, tenured professor of anesthesiology and perioperative medicine and psychiatry, director of the Center for Innovation in Pain Care, director of the Chronic Pain Research program, Departments of Anesthesia and Pain Medicine.

What makes doing this research at Pitt unique?

The intensely collaborative atmosphere at Pitt allows this research to thrive. This cross-disciplinary work is encouraged and celebrated, and makes it an ideal place for these diverse experiences to come together to find solutions for critical and complex health care problems.

The strong working relationships between the School of Medicine, School of Health and Rehabilitation Sciences and the School of Engineering ensure that we have the right team—working together without barriers—to accomplish the audacious goal of comprehensively phenotyping people with low back pain to understand all aspects of their experience.

What excites you the most about this project?

The most exciting thing is the opportunity to translate our findings into new clinical care approaches that will improve outcomes for this common condition.

How have the research participants made an impact on this work?

The original cohort of 1,007 people with chronic low back pain contributed an unprecedented amount of data to help us better understand their experience. We look forward to inviting them back after five years to see how they are doing, and we are very thankful for their commitment to this work.