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Awarded Grant - Acute Care

Chronic Pain Prevention after Spinal Cord Injury (SCI) and Limb Loss

FOA Number: CE04-044 - Grants for Acute Care, Rehabilitation, and Disability Prevention Research
Project Period: 8/01/04 – 07/31/07
Application/Grant Number: 1-R49-CE000483-01
Principal Investigator: Dawn Ehde, PhD
University of Washington
325 9th Avenue, Box 359740
Seattle, WA 98104
Phone: 206-731-2811
Fax: 206-731-8580


The broad, long-term objective of this project is to reduce the occurrence and associated suffering of chronic pain secondary to either spinal cord injury (SCI) or limb loss (LL). This research aims to accomplish the following:

  1. Compare how two in -hospital provided self-management interventions for pain management (either a hypnotic analgesia treatment or a cognitive treatment) and a control education treatment affect pain intensity, pain interference with activities, psychological distress, and quality of life among persons with a new SCI or LL who are at risk for chronic pain;
  2. Test possible biopsychosocial variables that can help determine who might benefit most from future interventions and assist researchers in further developing interventions to maximize efficacy;
  3. Result in treatment manuals to facilitate replication (in future research) and dissemination (among clinicians).

These aims will be accomplished by a two-phase study:

Phase I is a surveillance study in which individuals with a new onset of SCI or LL will be followed longitudinally from the acute care setting through 6 months post-injury (the time by which chronic pain develops). Biopsychosocial predictor variables will be collected within 1 week after SCI or LL injury to develop a protocol for identifying participants who develop acute pain and associated risk factors.

Phase II will be a randomized clinical trial in which persons who are identified as having severe acute pain following their injury will be assigned to one of three pain treatment conditions: a cognitive restructuring intervention, a hypnotic analgesia intervention, or an education control intervention. All of the eight-session interventions of individual therapy are adapted from currently practiced and empirically supported interventions for chronic pain where pain is the primary complaint. This study is unique in that these interventions have not been evaluated for their effectiveness in the prevention of chronic pain and related disability, nor have they been tested in the SCI or LL populations using a randomized clinical trial design. Measures of pain intensity, psychological functioning, pain interference with activities, participation, medical services use, and costs will be collected at pre- and post-treatment and at 3- and 6-month follow up.