Pain Mechanisms and Treatment

Principal Investigators

Dr. Dworkin Dr. Dworkin’s major research interests are (1) methodologic aspects of analgesic clinical trials and (2) treatment and prevention of chronic and acute neuropathic and musculoskeletal pain. The primary focus of his current research involves the identification of factors that increase the assay sensitivity of randomized clinical trials to detect differences between an efficacious treatment and a placebo control or comparison intervention. Ongoing studies are evaluating research designs and methods, clinical outcome assessments, statistical analyses, and benefit-risk evaluations used in randomized clinical trials and in studies with real-world data. This research and other efforts to improve the efficiency and informativeness of clinical trials of analgesic, anesthetic, and addiction interventions are being conducted under the auspices of the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks, and Pediatric Anesthesia Safety Initiative (ACTTION/PASI) public-private partnership with the FDA, of which he serves as Director.

For many years, Dr. Dworkin has also been very interested in identifying risk factors for the transition from acute to chronic pain and in evaluating interventions that have the potential to prevent chronic pain. One of the major results has been that patients with greater acute pain are more likely to develop chronic pain. This suggests that attenuating acute pain might prevent the development of chronic pain, and designing and conducting studies to test this hypothesis has been another focus of his efforts. Finally, for the past several years, Dr. Dworkin has been very interested in the design of randomized clinical trials of "classic psychedelics," including psilocybin and LSD. Psychedelics have shown promise in the treatment of various psychiatric disorders and chronic pain conditions; given the modest efficacy and problematic tolerability of existing treatments, psychedelics have the potential to improve the well-being of large numbers of patients around the world if clinical trials confirm their efficacy and safety

Jennifer Gewandter, PhD, MPH is an Associate Professor at the University of Rochester, a former Associate Director of the ACTTION public-private partnership, and the PI of the University of Rochester Clinical Hub of the NIH-sponsored Early Phase Pain Investigation Clinical Network (EPPIC-Net). Her research and scholarly activities are focused on optimizing the design, execution, and transparent dissemination of clinical trials for pain and peripheral neuropathy treatments as well as researching interventions for painful peripheral neuropathy. She has authored over 90 peer-reviewed publications and has served as an Associate editor for the Clinical Journal of Pain and Co-section editor for Pain Medicine. She has mentored over 30 medical students, residents, fellows, and clinical faculty in clinical research and scientific writing.

Dr. Joel Kent’s general area of research interest is in promoting symptom relief and functional restoration of patients with chronic nonmalignant pain. Within this realm, he has two focused areas of clinical interest. The first is in the critical assessment of outcomes associated with the use of chronic opioid therapy for the treatment of non-malignant pain. Opioid therapy is potentially helpful, but also carries significant potential liabilities. Despite the widespread use of opioids in this patient population, clinicians have relatively little objective medical evidence to guide their use of these agents in chronic pain patients. Thus, some of Dr. Kent’s research efforts are geared to identifying strategies to optimize this therapy and to ensure optimal outcomes when opioids are used to treat patients with chronic nonmalignant pain. He also has an interest in the treatment of neuropathic pain and has participated in studies evaluating treatments for this common condition.

Dr. Rajbala Thakur has been the principal investigator in numerous clinical studies to investigate new medications for the management of malignant and non-malignant pain conditions. These studies have included new and novel formulations of opioid medications as well as adjuvant medications for patients with neuropathic and visceral pain conditions. In addition she currently is a sub investigator in a ‘combined behavioral and analgesic trial for fibromyalgia’. More recent research work has been focused on developing clinical protocol for the use of Ketamine therapy in the treatment of intractable chronic pain conditions.

Dr. Annie Philip's research focuses on the outcomes of commonly performed pain procedures used to improve the quality of care for patients with chronic pain. Her research examines patient factors associated with better outcomes in patients undergoing genicular nerve radiofrequency ablation, which is a commonly performed procedure for chronic knee pain. She is currently investigating the utility of steroids after cervical and lumbar medial branch radiofrequency ablation. Dr. Philip is also the Principal Investigator of a study examining new pharmacologic treatments for knee pain due to osteoarthritis and a study examining the efficacy of topical medications in chemotherapy-induced peripheral neuropathy. She is a Co-Investigator on a study examining the efficacy of new treatments for adult and elderly patients with painful diabetic neuropathy.

Dr. Mark Williams is an Assistant Professor in the Department of Anesthesiology. His areas of research interest include pharmacologic and interventional analgesic clinical trials, particularly chronic neuropathic pain conditions. Dr. Williams is the PI of an industry-funded study of the topical treatment of post-surgical neuropathic pain and the site PI of an NIH-funded study of painful diabetic neuropathy. He is also collaborating with the Department of Neurosurgery to evaluate nerve blocks after subarachnoid hemorrhage. He has helped develop outcome measures for procedural sedation clinical trials and published several review articles highlighting methodological issues in pain clinical trials.