Preventing the Development of Chronic Pain: Treating PTSD at Acute Pain Onset

Although most people recover from acute pain (such as pain caused by injury, surgery, repetitive motion, or unknown causes), many people do not fully recover and will experience chronic pain. Untreated posttraumatic stress disorder (PTSD) appears to be a key risk factor for the transition from acute pain to chronic pain. However, few published studies have addressed the issue of preventing the transition from acute to chronic pain via PTSD reduction. This project will aim to test whether trauma-related PTSD symptoms can be reduced using either Stellate Ganglion Block (SGB) treatment or Cognitive Processing Therapy (CPT), and whether reducing PTSD symptoms can prevent the transition from non-injury based acute pain to chronic pain.

Inclusion Criteria:Age 18 to 70 yearsAbility to read and write English sufficiently to understand and complete study questionnaires and participate in interviewsPresenting to the Rush Emergency Department (ED) with a medical problem and experiencing non-injury based acute painA primary acute pain site of back, shoulder, abdomen, or pelvisSelf-reported symptoms consistent with a diagnosis of PTSDExclusion Criteria:Pain intensity great enough to impair concentration or capacity to understand instructions or nature of being invited into a study, as assessed by a member of medical staffAny illness or injury that precludes the ability to understand or follow instructions, as assessed by a member of the medical staffCurrent illness that involves constant or frequent painSelf-reported history of chronic pain on presentation to the ED or documented in the electronic medical recordPain from the traumatic event that is the source of their PTSDTraumatic brain injury in the past 5 yearsNeurological disorderCancer diagnosisBlood pressure greater than 160/100 mmHgTaking anticoagulants or antiplatelet drugs other than aspirinPregnancyReceiving treatment for chronic or significant disease such as diabetes, rheumatoid disease, current influenza that may manifest temporary flu-related pain, HIV/AIDS, and heart diseaseMeet criteria for present psychotic or bipolar disorders