The human back is a complex structure with bones, nerves, tendons, discs, and more — all places where something can go wrong and cause pain, which, for many people, becomes a long-term or chronic problem. Life stresses and other medical and mental health conditions aggravate the problem. With so many pieces, it’s hard to get a holistic view of the puzzle or pinpoint the cause of the pain. “People tend to focus on one aspect or another,” said Jeffrey Lotz, Ph.D., a medical engineer who studies back pain at the University of California, San Francisco. “Some people think it’s largely

HEAL-funded researcher Conor Walsh, Ph.D., and his team at the Harvard Biodesign Lab specialize in developing soft “exosuits” – wearable devices that help people with muscle weakness (for example, after a stroke) so they can regain movement and muscle strength.

Back pain is one of the most common forms of chronic pain affecting adults. People with chronic back pain often take opioids for pain management, but opioids are highly addictive. To address this public health challenge, in 2019 NIH launched the Back Pain Consortium (BACPAC) Research Program, part of the NIH Helping to End Addiction Long-term® (HEAL) Initiative that launched in 2018, a patient-centered effort to address the need for non-addictive, effective and personalized therapies for chronic back pain. Scientists are conducting clinical trials with the hopes of finding new non-opioid treatments. Yet for clinical trials to be effective, the

The HEAL-funded Biomarkers for Evaluating Spine Treatments (BEST) clinical trial is taking an innovative approach. This large collaborative study – developed by the Back Pain Consortium (BACPAC) Research Program – aims to learn what back pain treatment or sequence of treatments are most effective for people based on their unique traits.

NIAMS and several other NIH institutes were selected by Congress to receive funding that would enhance opportunities for advancing pain science. These projects will help to accelerate research into the underlying mechanisms of pain in rheumatic, skin, and musculoskeletal diseases.

As I settle into my new role as director of NIAMS, I have the honor of leading the Institute on its 35th anniversary.

BACPAC is designed to take a comprehensive approach to understanding and treating back pain. This issue of Pain Medicine contains important information on these efforts.

Dear Colleagues, From the Hippocratic corpus, the author writes, “I consider the responsibility of medicine to be to entirely relieve the suffering of the sick and to blunt the extremities of disease” (The Art 3.4-7)1. Note that despite the acknowledgment that disease may only be blunted, in promoting health it is our duty to relieve suffering wherever possible.

Carpal tunnel syndrome usually begins with numbness or a burning sensation in the hands and fingers – at night or first thing in the morning. The condition is caused by pressure on the median nerve traveling down the arm to the fingers.

Understanding and treating joint pain is important to improving long-term health—and a fundamental part of the NIAMS mission. With that imperative in mind, I’m delighted that NIAMS is supporting a new Consortium that may lead us closer to ultimately being able to restore joint health. The Restoring Joint Health and Function to Reduce Pain (RE-JOIN) Consortium is part of the Helping to End Addiction Long-term® Initiative, or NIH HEAL Initiative®, an aggressive, trans-NIH effort to speed scientific solutions to stem the national opioid public health crisis.