U-M to launch $16.5M NIH-funded project to advance personalized treatment for chronic lower back pain

The University of Michigan Medical School Department of Anesthesiology has been awarded a $16.5 million grant from the National Institutes of Health (NIH) to improve the treatment of chronic low back pain through personalized medicine approaches that match interventions to individual patient characteristics and needs. 

Funding is provided by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), as part of the NIH HEAL (Helping to End Addiction Long-term) Initiative. 

“Despite the range of treatments available for chronic pain, only about a third of patients experience significant benefit from any one approach,” said Daniel Clauw, MD, professor of anesthesiology and rheumatology and one of the study’s principal investigators. 

“Our vision is for a future where clinicians can use brief but powerful assessments to match each patient to the intervention most likely to help them, moving beyond trial-and-error care.” 

For many people with chronic low back pain, finding relief can mean years of cycling through different treatments, trying one after another before finally discovering what helps.  

The study seeks to change this current experience by helping doctors recommend the right treatment, the first time. Instead of relying on trial and error, the research team aims to develop practical ways for providers to use information such as a patient’s medical history, life experiences, and responses to brief questionnaires or simple office tests to guide treatment choices. 

“We hear so often from patients about the frustration of what is typically a hit-and-miss process,” said Afton Hassett, PsyD, associate professor of anesthesiology and co-principal investigator. “Our goal is to develop solutions that are accessible for any clinic, so more people get meaningful relief, sooner.” 

Researchers will build on years of following patients who participated in earlier U-M studies, continuing to learn from their experiences with various treatments over time. By collecting more detailed information about these participants, the team hopes to better understand what factors influence whether a treatment works for an individual.  

The team then will recruit 500 new study volunteers to test whether using this personalized approach helps more people find relief by matching patients to treatments based on their unique characteristics.  

A key part of the project is to involve people with lived experience of chronic pain not only as participants, but as partners in the research. “We’re bringing patients and advocates into the study team from the start to help us design studies that truly fit the needs of those living with chronic pain,” Hassett said. The project also draws on the expertise of a large multidisciplinary team, including specialists in pain medicine, pain psychology, rehabilitation, radiology, statistics, biomechanics and more. 

The study builds on the University of Michigan’s leadership in the NIH Back Pain Consortium (BACPAC), where U-M played a key role as a Mechanistic Research Center. Through BACPAC, U-M’s team established a unique group of participants and led studies comparing medications, physical therapy, behavioral therapies, and mobile app-based self-management for chronic pain. 

The ultimate goal is to make individualized, effective chronic pain care more accessible and routine. 

“If we can demonstrate that better understanding key characteristics in our patients will allow us to identify who will respond best to each therapy, we could improve care for those suffering from chronic low back pain, and ultimately, for millions living with chronic pain,” Clauw said.